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Jung E, Youn SH, Shin KY, Shin HJ, Yang JY, Yang Y, Jung JH, Kim Y. Investigation of symmetric dimethylarginine as a serologic marker for kidney function in striped skunks ( Mephitis mephitis). J Vet Sci 2024; 25:e52. [PMID: 39083204 PMCID: PMC11291430 DOI: 10.4142/jvs.24057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 06/27/2024] [Accepted: 07/03/2024] [Indexed: 08/03/2024] Open
Abstract
IMPORTANCE Kidney disease is prevalent among veterinary species, including zoo animals; however, investigations into this condition in striped skunks (Mephitis mephitis) are scarce. Diagnostic tools for kidney diseases in this species also remain limited. OBJECTIVE This study aimed to assess the utility of symmetric dimethylarginine as a biomarker for kidney disease in captive striped skunks in Korea. METHODS This retrospective study analysed 11 striped skunks housed at the Everland Zoo between 2017 and 2021. Blood samples were collected during health checks. Kidney function was assessed through blood analysis and diagnostic ultrasound, with necropsies conducted on deceased animals. Symmetric dimethylarginine levels were measured in 27 plasma samples collected from 11 skunks. RESULTS Over the study period, seven skunks were diagnosed with kidney disease. Analysis of 27 blood samples revealed a concurrent increase in SDMA levels with concentrations of blood urea nitrogen and blood creatinine. In 3 of the 7 skunks with kidney disease, symmetric dimethylarginine exceeded 14 µg/dL prior to the elevation of blood urea nitrogen and blood creatinine above the upper reference limit. CONCLUSIONS AND RELEVANCE To our knowledge, this is the first study investigating symmetric dimethylarginine in captive striped skunks in Korea. Our findings suggest that symmetric dimethylarginine may serve as an early and consistent biomarker for renal dysfunction in striped skunks. Further studies with larger clinical sample size from striped skunks are needed to validate the clinical utility of blood symmetric dimethylarginine concentration.
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Affiliation(s)
- Eun Jung
- Laboratory of Veterinary Clinical Pathology, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
- Everland Animal Hospital, Yongin 17023, Korea
| | | | | | | | | | - Yeseul Yang
- Laboratory of Veterinary Clinical Pathology, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
- BK21 PLUS Program for Creative Veterinary Science Research, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Jae-Ha Jung
- Laboratory of Veterinary Clinical Pathology, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
- BK21 PLUS Program for Creative Veterinary Science Research, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Yongbaek Kim
- Laboratory of Veterinary Clinical Pathology, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
- Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea.
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Wun MK, Broughton-Neiswanger LE, Villarino NF. Comparison of serum SDMA and creatinine as a biomarker for the detection of meloxicam-induced kidney injury in cats. Front Vet Sci 2024; 11:1395505. [PMID: 38812562 PMCID: PMC11133641 DOI: 10.3389/fvets.2024.1395505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/02/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction Serum symmetric dimethylarginine (SDMA) and creatinine are commonly used biomarkers of renal function in cats. We hypothesize that the serum analytes creatinine and SDMA are equally effective at detecting impaired renal function caused by meloxicam-induced renal injury in cats. Our primary objective was to compare serum concentrations of SDMA and creatinine in cats before, during, and after induction of renal injury from repeated dosages of meloxicam in the context of a small pilot study. Methods This follow-up study results from data collected in a well-controlled study that included 12 healthy female adult purpose-bred cats. Cats in the treatment group received meloxicam 0.3 mg/kg subcutaneously (SC) every 24 h for 31 days. Cats in the control group received saline (0.1 mL SC). Renal injury was defined as the presence of tubular damage, basement membrane damage, and/or interstitial inflammation in histological sections of kidney tissue. Serum creatinine and SDMA concentration were measured every 4 days. Results In the control group, no cats developed renal azotemia. In the treatment group, four out of six cats developed elevated serum creatinine and histopathological evidence of renal injury. Three of these cats developed an elevation in serum SDMA. The time to the development of renal azotemia using serum creatinine or SDMA was not significantly different (p > 0.05). Discussion In this pilot study, there was no evidence that serum SDMA was superior to serum creatinine at detecting impaired renal function caused by meloxicam-induced renal injury in cats.
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Affiliation(s)
- Matthew K. Wun
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, United States
| | - Liam E. Broughton-Neiswanger
- Department of Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA, United States
| | - Nicolas F. Villarino
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, United States
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Nóbrega JCD, Dinallo HR, Geraldes SS, Azevedo MGPD, Moraes RSD, Maia SR, Souza FFD, Melchert A, García HDM, Andreatti Filho RL, Okamoto AS, Okamoto PTCG. Symmetric dimethylarginine correlates with the urea, creatinine, potassium, and clinical scores in feline urethral obstructions. J Vet Sci 2024; 25:e27. [PMID: 38568828 PMCID: PMC10990919 DOI: 10.4142/jvs.23268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/08/2024] [Accepted: 01/30/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND A urethral obstruction (UO) is an emergency commonly observed in male cats, which can result in significant clinical and laboratory alterations, leading to complications and death. OBJECTIVES This study aimed to correlate symmetric dimethylarginine (SDMA) with the urea, creatinine, potassium, and bicarbonate levels in cats with UO. In addition, the correlation between clinical score and time of obstruction was evaluated. METHODS Thirty male cats were selected and allocated into a control group (CG, n = 13) and an obstruction group (OG, n = 17). The laboratory analyses were conducted before treatment (M0) and at different times after treatment (12 h [M12], 24 h [M24], and 48 h [M48]). Correlations were established between SDMA and creatinine, urea, bicarbonate, potassium, time of obstruction, and the clinical score. RESULTS A strong correlation (r > 0.6) was observed between SDMA and creatinine, urea, and potassium in the OG. Furthermore, there was substantial agreement (kappa value) between SDMA and creatinine at M24. A higher clinical score was associated with a longer time of obstruction. In the OG, at M48, the SDMA and creatinine levels were 50% and 41.2% higher, respectively. CONCLUSIONS A correlation was observed between SDMA and creatinine in obstructed cats, and significant agreement between these values was observed 24 h after the unblocking treatment. A correlation among SDMA, urea, and potassium was observed. Approximately 9% more cats continued to have elevated SDMA levels after 48 h of treatment compared to creatinine. This suggests a slightly lower sensitivity of the latter biomarker but does not exclude the possibility of congruent and normalized values after a longer evaluation period.
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Affiliation(s)
- Jéssica Cavalcante da Nóbrega
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
| | - Heloíse Rangel Dinallo
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
| | - Silvano Salgueiro Geraldes
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
| | - Maria Gabriela Picelli de Azevedo
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
| | - Reiner Silveira de Moraes
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
| | - Suellen Rodrigues Maia
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
| | - Fabiana Ferreira de Souza
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
| | - Alessandra Melchert
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
| | - Henry David Mogollón García
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
| | - Raphael Lúcio Andreatti Filho
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
| | - Adriano Sakai Okamoto
- Department of Veterinary Clinics, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, 18618-681, São Paulo, Brazil
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da Cruz Schaefer G, de Mattos Brose M, Herrera Becerra JR, Bernhardt Rovaris I, Peixoto da Silva Mello F, Schneck Simão B, de Faria Valle S, Poletto Ferreira M, Vieira Amorim da Costa F. Comparison of serum creatinine, point-of-care symmetric dimethylarginine and renal imaging with glomerular filtration rate measured by renal scintigraphy in healthy and early chronic kidney diseased cats. Vet Res Commun 2023; 47:1845-1859. [PMID: 37133704 DOI: 10.1007/s11259-023-10131-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 04/23/2023] [Indexed: 05/04/2023]
Abstract
The aim of this study was to evaluate routinely used tests to diagnose cats in early stages of chronic kidney disease (CKD) and to describe a model for evaluating these variables simultaneously. Apparently healthy cats were screened using serum creatinine (sCr), point-of-care symmetric dimethylarginine (POC SDMA), urinalysis, urine protein/creatinine ratio (UPC) and imaging evaluation. Those parameters were compared to glomerular filtration rate (GFR) assessed by renal scintigraphy. Forty-four cats were included and consisted of 14 (31.8%) healthy cats (absence of abnormalities in renal morphology and sCr less than 1.6 mg/dL), 20 (45.5%) cats classified as CKD I (presence of abnormalities in renal morphology and sCr less than 1.6 mg/dL) and ten (22.7%) as CKD II (sCr equal to or greater than 1.6 mg/dL, with or without abnormalities in renal morphology). A large number (40.9%) of apparently healthy cats presented reduction in GFR, which included half of CKD I patients. Point-of-care SDMA was not a good predictor for decreased GFR, nor was it correlated with the variables GFR and sCr. Glomerular filtration rate was significantly lower in CKD I and II groups in comparison with healthy cats, but there was no significant difference between the CKD I and II groups. Multivariate logistic regression model identified three variables that affected the odds of a cat having decreased GFR (< 2.5 mL/min/kg): sCr (OR = 18.3; p = 0.019; CI = 1.6-207.2), and the ultrasonographic findings 'reduced corticomedullary definition' (OR = 19.9; p = 0.022; CI = 1.6-254.0) and 'irregular contour' (OR = 65.6; p = 0.003; CI = 4.2-1038.2). Renal ultrasonography evaluation should always be considered for screening early CKD in apparently healthy cats.
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Affiliation(s)
- Gabriela da Cruz Schaefer
- Post-Graduate Program in Veterinary Science, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil.
| | - Mariana de Mattos Brose
- Hospital de Clínicas Veterinárias, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - José Ricardo Herrera Becerra
- Post-Graduate Program in Veterinary Science, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Inácio Bernhardt Rovaris
- Post-Graduate Program in Veterinary Science, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | | | - Bianca Schneck Simão
- Post-Graduate Program in Veterinary Science, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Stella de Faria Valle
- Department of Veterinary Clinical Pathology, College of Veterinary, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Márcio Poletto Ferreira
- Department of Animal Medicine, College of Veterinary, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, RS, Brazil
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Cowgill LD, Segev G, Vaden S, Ross S, Dufayet C, Cohn LA, Nabity M, Farace G, Szlosek D, Ouyang Z, Peterson S, Beall M, Yerramilli M, Polzin D. Differentiation of stable kidney function versus progressive dysfunction in dogs. J Vet Intern Med 2023; 37:2241-2250. [PMID: 37861343 PMCID: PMC10658543 DOI: 10.1111/jvim.16885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/15/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Circulating creatinine and symmetric dimethylarginine (SDMA) are biomarkers of kidney function that have been used variously to define stable vs progressive chronic kidney disease (CKD). Slope monitoring of inverse biomarker values (creatinine-1 or SDMA-1 ) has shown promise, but quantitative criteria to distinguish stable vs progressive CKD using this approach are lacking. OBJECTIVE Assessment of creatinine-1 and SDMA-1 slope cutoffs to distinguish stable vs progressive CKD. ANIMALS One hundred ten clinically healthy university staff-owned dogs and 29 male colony dogs with progressive X-linked hereditary nephropathy (XLHN). METHODS Retrospective analysis combining 2 prospective observational studies, 1 tracking kidney function biomarkers in healthy dogs (HDs) to a maximum of 3 years, and 1 tracking kidney function biomarkers in male colony dogs with progressive XLHN to a maximum of 1 year. The minimum slope of creatinine-1 or SDMA-1 as measured using the IDEXX SDMA test from HD was assigned as the slope cutoff for stable kidney function. RESULTS The stable vs progressive slope cutoff was -0.0119 week × dL/mg for creatinine-1 and -0.0007 week × dL/μg for SDMA-1 . CONCLUSIONS AND CLINICAL IMPORTANCE In the studied CKD population, progressive dysfunction can be distinguished from stable kidney function by using the slope of creatinine-1 or SDMA-1 . These criteria may serve to characterize CKD in other cohorts of dogs and to establish guidelines for degrees of progression rate in dogs with naturally occurring CKD.
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Affiliation(s)
| | | | - Shelly Vaden
- North Carolina State UniversityRaleighNorth CarolinaUSA
| | - Sheri Ross
- University of Prince Edward IslandCharlottetownPrince Edward IslandCanada
| | - Cedric Dufayet
- University of California Veterinary Medical Center‐San DiegoSan DiegoCaliforniaUSA
| | - Leah A. Cohn
- University of Missouri Veterinary Health CenterColumbiaMissouriUSA
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Foster JD, Abouraya M, Papich MG, Muma NA. Population pharmacokinetic analysis of enrofloxacin and its active metabolite ciprofloxacin after intravenous injection to cats with reduced kidney function. J Vet Intern Med 2023; 37:2230-2240. [PMID: 37728198 PMCID: PMC10658592 DOI: 10.1111/jvim.16866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/24/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND It is unknown if enrofloxacin accumulates in plasma of cats with reduced kidney function. HYPOTHESIS To determine if enrofloxacin and its active metabolite ciprofloxacin have reduced clearance in azotemic cats. ANIMALS Thirty-four cats hospitalized for clinical illness with variable degree of kidney function. METHODS Prospective study. After enrofloxacin (dose 5 mg/kg) administration to cats, sparse blood sampling was used to obtain 2 compartment population pharmacokinetic results using nonlinear mixed-effects modeling. Plasma enrofloxacin and ciprofloxacin concentrations were measured and summed to obtain the total fluoroquinolone concentration. A model of ciprofloxacin metabolism from enrofloxacin was created and evaluated for covariate effects on clearance, volume of distribution, and the metabolic rate of ciprofloxacin generation from enrofloxacin. RESULTS Body weight was the only covariate found to affect total fluoroquinolone volume of distribution (effect 1.63, SE 0.19, P < .01) and clearance (effect 1.63, SE 0.27, P < .01). Kidney function did not have a significant effect on total fluoroquinolone clearance (median 440.8 mL/kg/h (range 191.4-538.0 mL/kg/h) in cats with normal kidney function, 365.8 mL/kg/h (range 89.49-1092.0 mL/kg/h) in cats with moderate kidney dysfunction, and 308.5 mL/kg/h (range 140.20-480.0 mL/kg/h) in cats with severe kidney dysfunction (P = .64). Blood urea nitrogen concentration influenced the metabolic generation of ciprofloxacin from enrofloxacin (effect 0.51, SE 0.08, P < .01), but other markers of kidney function did not. CONCLUSIONS AND CLINICAL IMPORTANCE Adjustment of enrofloxacin dosage is not indicated for azotemic cats.
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Affiliation(s)
| | | | - Mark G. Papich
- College of Veterinary MedicineNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Nancy A. Muma
- Department of Pharmacology and ToxicologyUniversity of KansasLawrenceKansasUSA
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Brans M, Marynissen S, Mortier F, Duchateau L, Daminet S, Paepe D. Effect of storage temperature and time on measurement of serum symmetric dimethylarginine concentration using point-of-care and commercial laboratory analyzers in cats and dogs. J Vet Intern Med 2023; 37:1794-1805. [PMID: 37565515 PMCID: PMC10472997 DOI: 10.1111/jvim.16811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 07/03/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Stability of serum symmetric dimethylarginine (sSDMA) during short- and long-term storage has not been assessed for the immunoassay of the Point-of-Care IDEXX Catalyst DX (POC) analyzer and the Enzyme Multiplied Immunoassay Technique of IDEXX commercial laboratory (CL). Also, the agreement between both analyzers is questioned. OBJECTIVES To determine (a) the effect of storage time and temperature on sSDMA measured by POC and CL; (b) the agreement between sSDMA measured by POC and CL; and (c) the imprecision of the POC. ANIMALS Serum of cats (n = 17) and dogs (n = 18) with a range of SDMA concentrations (6 to >100 μg/dL). METHODS Based on an equivalence trial with predefined equivalence range (-3.0 to +3.0 μg/dL) and using T0 as baseline, stability was evaluated after 24 hours at 22°C and 4°C (POC); after 7 days at 4°C (POC and CL) and after 10 and 24 months at -24°C and -80°C (CL). Bland-Altman plots enabled method comparison. Imprecision of the POC was assessed by duplicate sSDMA measurements at T0. RESULTS The POC analyzer produced equivalent sSDMA measurements if samples were stored for 24 hours at 4°C (95% confidence interval [CI]: -2.5-2.0 μg/dL), but not when stored for 24 hours at room temperature (RT; 95% CI: -4.1 to 0.5 μg/dL) or after 7 days at 4°C (95% CI: -3.6-1.0 μg/dL). The CL analyzer was less affected by preanalytical variation with clinically similar results obtained when samples were stored for 7 days at 4°C (95% CI: -2.2 to 2.4 μg/dL) and for at least 24 months at -24°C (95% CI: -1.7 to 2.9 μg/dL) and -80°C (95% CI: -1.5 to 3 μg/dL). A relevant mean difference of -2.3 μg/dL between both analyzers was found. Duplicate POC measurements were equivalent (95% CI: -2.6 to 2.0 μg/dL). CONCLUSIONS Delayed analysis may significantly change sSDMA depending on storage and measurement conditions. Interchangeable use of assays should be done with caution because analytical variation could be interpreted as clinically relevant change.
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Affiliation(s)
- Marleen Brans
- Small Animal Department, Faculty of Veterinary MedicineGhent UniversityGhentBelgium
| | - Sofie Marynissen
- Small Animal Department, Faculty of Veterinary MedicineGhent UniversityGhentBelgium
| | - Femke Mortier
- Small Animal Department, Faculty of Veterinary MedicineGhent UniversityGhentBelgium
| | - Luc Duchateau
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and NutritionGhent UniversityGhentBelgium
| | - Sylvie Daminet
- Small Animal Department, Faculty of Veterinary MedicineGhent UniversityGhentBelgium
| | - Dominique Paepe
- Small Animal Department, Faculty of Veterinary MedicineGhent UniversityGhentBelgium
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Gultekin G, Pasa S, Ural K, Erdogan H, Gonulveren G, Gultekin M. Arginine, symmetric and asymmetric dimethylarginine levels in canine leishmaniasis. Microb Pathog 2023; 178:106085. [PMID: 36963705 DOI: 10.1016/j.micpath.2023.106085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/26/2023]
Abstract
The study aimed to investigate the levels of arginine, symmetric dimethylarginine (SDMA), and asymmetric dimethylarginine (ADMA) in dogs with canine leishmaniasis (CanL) and their relationship with some renal and cardiovascular parameters. A total of 60 dogs were enrolled, including 40 with CanL and 20 healthy controls. The CanL group was divided into four stages based on clinical and laboratory findings. The levels of plasma arginine, SDMA, and ADMA were determined by high performance liquid chromatography (HPLC). The data from the healthy group were compared with those from the CanL group, and according to the stages. In dogs with CanL, systolic and diastolic blood pressure, plasma creatinine, cystatin-C, phosphorus, potassium, and low-density lipoprotein concentrations, the urine protein/creatinine ratio, the amount of nitric oxide, and creatine kinase-MB activity were higher, while the high-density lipoprotein concentration was lower compared to healthy controls. The concentration of arginine was low (p < 0.05) and the levels of ADMA (p < 0.001) and SDMA (p < 0.05) were high in dogs with CanL. There were no statistically significant differences in arginine concentration among the different stages of CanL. However, the concentration of plasma ADMA was higher in all stages of CanL compared to the healthy group, and the concentration of plasma SDMA was higher in Stage IV compared to the healthy group and Stage III. The present study demonstrates for the first time a decrease in arginine concentration and an increase in ADMA concentration in dogs with CanL. The increase in SDMA concentration in dogs with CanL was consistent with previous studies. However, compared to other renal parameters, SDMA exhibited limited performance distinguishing between clinical stages of CanL. These findings could be a source for future diagnostic and therapeutic studies to explain the renal and cardiovascular pathophysiology of CanL. Additional clinical studies that include treatment and patient follow-up with an assessment of the acute phase response are needed to provide a more detailed understanding of the changes observed in dogs with CanL.
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Affiliation(s)
- Gamze Gultekin
- Department of Biochemistry, Faculty of Veterinary Medicine, University of Aydin Adnan Menderes, Aydin, Turkey
| | - Serdar Pasa
- Department of Internal Medicine, Faculty of Veterinary Medicine, University of Aydin Adnan Menderes, Aydin, Turkey
| | - Kerem Ural
- Department of Internal Medicine, Faculty of Veterinary Medicine, University of Aydin Adnan Menderes, Aydin, Turkey
| | - Hasan Erdogan
- Department of Internal Medicine, Faculty of Veterinary Medicine, University of Aydin Adnan Menderes, Aydin, Turkey
| | - Gizem Gonulveren
- Department of Internal Medicine, Faculty of Veterinary Medicine, University of Aydin Adnan Menderes, Aydin, Turkey
| | - Mehmet Gultekin
- Department of Internal Medicine, Faculty of Veterinary Medicine, University of Aydin Adnan Menderes, Aydin, Turkey.
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Van Vertloo LR, Palerme JS, Miles KG, Bourgois-Mochel A, Jergens AE. Changes in symmetric dimethylarginine and glomerular filtration rates in hyperthyroid cats undergoing radioiodine therapy. J Feline Med Surg 2023; 25:1098612X231160128. [PMID: 36892005 PMCID: PMC10812008 DOI: 10.1177/1098612x231160128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
OBJECTIVES The aims of this study were to evaluate concentrations of symmetric dimethylarginine (SDMA) in hyperthyroid cats before and after radioiodine treatment, and to compare results with other variables used to assess kidney function in cats (creatinine, urine specific gravity [USG] and glomerular filtration rate [GFR] measured by renal scintigraphy). METHODS Thirteen cats diagnosed with hyperthyroidism based on clinical signs and increased serum total thyroxine (TT4) were included in this prospective study. Study design included physical examination, complete blood count, serum chemistry, TT4, urinalysis and SDMA before treatment (T0) and at 1 month (T1) and 3 months post-treatment (T3). GFR was quantified by renal scintigraphy at T0 and T3. RESULTS Median GFR decreased significantly from baseline (3.18 ml/kg/min; range 1.35-4.87) at T3 (2.22 ml/kg/min; range 1.81-3.42 [P = 0.005]). While median creatinine and serum urea nitrogen increased post-treatment (creatinine: T0 = 0.8 mg/dl [range 0.4-1.1], T1 = 1.3 mg/dl [range 0.9-2]; T3 = 1.65 mg/dl [range 0.8-2.8]; P <0.001; serum urea nitrogen: T0 = 23 mg/dl [range 15-26]; T1 = 27 mg/dl [range 20-40]; T3 = 27.5 mg/dl [range 20-36]; P <0.001), SDMA and USG did not change significantly (SDMA: T0 = 11 µg/dl [range 7-15]; T1 = 12 µg/dl [range 6-16]; T3 = 10.5 µg/dl [range 8-21]; P = 0.789; USG: T0 = 1.030 [range 1.011-1.059]; T1 = 1.035 [range 1.012-1.044]; T3 = 1.030 [range 1.007-1.055]; P = 0.792). CONCLUSIONS AND RELEVANCE Our data suggest that factors other than GFR may affect serum SDMA in hyperthyroid cats and that SDMA does not offer an advantage over other biomarkers traditionally used to predict changes in renal function following radioiodine therapy.
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Affiliation(s)
- Laura R Van Vertloo
- Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, USA
| | - Jean-Sébastien Palerme
- Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, USA
| | - Kristina G Miles
- Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, USA
| | - Agnes Bourgois-Mochel
- Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, USA
| | - Albert E Jergens
- Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, USA
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EVALUATION OF SYMMETRIC DIMETHYLARGININE AS AN ENDOGENOUS MARKER OF RENAL DISEASE IN GREATER FLAMINGOS ( PHOENICOPTERUS ROSEUS). J Zoo Wildl Med 2023; 53:644-653. [PMID: 36640065 DOI: 10.1638/2021-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 01/09/2023] Open
Abstract
Detection of renal disease in birds is currently reliant on biochemical measures such as uric acid, which is only elevated after significant renal compromise has occurred. Symmetric dimethylarginine (SDMA) production has not been previously evaluated in birds and no reference intervals (RI) for measurement exist in avian species. This study aimed to develop an RI for SDMA in greater flamingos (Phoenicopterus roseus) and evaluate the association between SDMA levels and renal disease. Blood from 60 flamingos was collected for RI development and the RI of SDMA was found to be 11.8-34.2 µg/dl. Symmetric dimethylarginine showed a strong positive correlation with uric acid, a moderate positive correlation with creatine kinase, and moderate negative correlations with total protein, albumin, and glucose. No correlation was found with pododermatitis score or body condition. Using the SDMA RI, six clinical cases were included for assessment of the clinical relevance of SDMA in renally compromised patients. All birds that were euthanized had elevated SDMA levels and severe renal or systemic pathology on necropsy.
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11
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Cavalcante CZ, Michelotto PV, Capriglione LGA, Roncoski AT, Nishiyama A. Weight loss modifies lipid peroxidation and symmetric dimethylarginine levels in obese dogs. CANADIAN JOURNAL OF VETERINARY RESEARCH = REVUE CANADIENNE DE RECHERCHE VETERINAIRE 2023; 87:29-34. [PMID: 36606041 PMCID: PMC9808880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 07/21/2022] [Indexed: 01/07/2023]
Abstract
In obese dogs, oxidative stress is associated with inflammatory processes and systemic endocrine imbalances. Monitoring oxidative status is an early and valuable means of obesity control as it is a marker of weight loss, which leads to a reduction in oxidative status or injury potential. The objective of this study was to investgate the changes in the concentrations of thiobarbituric acid reactive substances (TBARS) and symmetric dimethylarginine (SDMA) in obese female dogs subjected to an 8-week weight-loss program. We included obese female dogs without comorbidities and with body condition scores (BCS) of 8 and 9 out of 9. In addition to TBARS and SDMA assessments, laboratory tests of blood and urine (blood count; levels of serum biochemistry; albumin, alanine aminotransferase, alkaline phosphatase, creatinine, urea, triglycerides, cholesterol, and glucose; urinalysis; and albuminuria), systolic blood pressure, and hormone concentrations (insulin, cortisol, and free thyroxine) were carried out before and after the weight-loss program. All the obese dogs presented high TBARS levels. After the program, the dogs showed significant reductions in TBARS (P = 0.005) and SDMA (P = 0.0013). In conclusion, obese female dogs were prone to lipid peroxidation and the TBARS and SDMA levels decreased after the 8-week weight-loss program.
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12
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Wilson KE, Berent AC, Weisse CW, Szlosek D. Assessment of serum symmetric dimethylarginine and creatinine concentrations in cats with urethral obstruction. J Feline Med Surg 2022; 24:1017-1025. [PMID: 34894831 PMCID: PMC10812315 DOI: 10.1177/1098612x211060677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aims of this study were to evaluate serum symmetric dimethylarginine (SDMA) and creatinine concentrations in cats with urethral obstruction pre- and post-decompression of the obstruction, and to determine if pre-decompression values were predictive of post-decompression renal function, as measured by SDMA and creatinine. METHODS This was a prospective observational study. Twenty-five client-owned cats with urethral obstruction were hospitalized for decompression of the obstruction. Serum SDMA and creatinine were prospectively assessed at presentation, 24 h post-decompression and 5-20 days post-decompression. Urinalysis and culture were assessed at presentation and at the final follow-up. Exclusion criteria included positive urine culture, reobstruction or failure to obtain required samples. RESULTS Mean SDMA concentration dropped by 41.8% from an initial pre-decompression concentration of 17.6 µg/dl to 10.3 µg/dl 24 h post-decompression (P <0.001). The mean creatinine value dropped by 38.4% from an initial pre-decompression concentration of 2.5 mg/dl to 1.5 mg/dl 24 h post-decompression (P <0.001). There was no association between SDMA concentration at initial presentation and SDMA concentration 5-20 days after urethral catheterization (Spearman's ρ = 0.205, P = 0.314). Creatinine concentration upon initial presentation was associated with the 5-20 day values after urethral catheterization (Spearman's ρ = 0.583, P <0.002). Twenty percent of cases were excluded due to bacterial growth on initial urine culture. SDMA and creatinine concentrations were significantly higher in these cases (median 59 µg/dl and 10.9 mg/dl, respectively) compared with those with negative cultures (median 14 µg/dl and 1.6 mg/dl [P <0.002 and P <0.001], respectively). CONCLUSIONS AND RELEVANCE Both SDMA and creatinine decreased significantly after urethral catheterization, suggesting that renal function post-decompression cannot be predicted by the pre-decompression concentrations of these values.
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Affiliation(s)
- Kendall E Wilson
- Department of Internal Medicine, Cornell University Veterinary Specialists, Stamford, CT, USA
| | - Allyson C Berent
- Department of Interventional Radiology & Endoscopy, The Animal Medical Center, New York, NY, USA
| | - Chick W Weisse
- Department of Interventional Radiology & Endoscopy, The Animal Medical Center, New York, NY, USA
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Symmetric Dimethylarginine is a Promising Biomarker for the Early Detection of Age-Related Kidney Dysfunction in Zoo Felids. ACTA VET-BEOGRAD 2022. [DOI: 10.2478/acve-2022-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Chronic renal failure is one of the leading causes of death in African lions, cheetahs, and tigers. Conventional methods to measure renal dysfunction include measuring serum creatinine and blood urea nitrogen (BUN). Symmetric dimethylarginine (SDMA) measurement is a reliable predictor of renal dysfunction in the domestic cat because SDMA serum levels increase early when the kidneys are damaged. Serum SDMA levels were assessed and correlated with creatinine as well as BUN from healthy captive Bengal tigers and lions at the Everland Zoo in Korea. Serum SDMA concentrations were increasingly associated with increased age in lions. However, SDMA concentrations were higher in some young Bengal tigers than in older ones, which may allow for earlier renal dysfunction detection in these young cats than would be BUN and creatinine alone. In Bengal tigers, the correlation between the SDMA and BUN was slightly higher than that between SDMA and creatinine. In lions, SDMA correlated better with creatinine than with BUN concentration. These results show that serum SDMA concentration can be used as a biomarker for age-associated renal dysfunction. SDMA measurement may be an essential preventive management method in zoos.
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Yu L, Lacorcia L, Johnstone T. Hyperthyroid cats and their kidneys: a literature review. Aust Vet J 2022; 100:415-432. [PMID: 35711100 PMCID: PMC9543258 DOI: 10.1111/avj.13179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/28/2022] [Accepted: 05/01/2022] [Indexed: 11/28/2022]
Abstract
Hyperthyroidism and chronic kidney disease (CKD) are common diseases of geriatric cats, and often occur concurrently. Thus, a thorough understanding of the influence of thyroid function on renal function is of significant value for all feline practitioners. Among other effects, hyperthyroidism causes protein catabolism and increases renal blood flow and glomerular filtration rate (GFR). These effects render traditional renal markers insensitive for the detection of CKD in cats with uncontrolled hyperthyroidism. Furthermore, the development of iatrogenic hypothyroidism with over treatment of hyperthyroidism can be detrimental to renal function and may negatively affect long-term survival. This review discusses important diagnostic considerations of feline hyperthyroidism, as well as key treatment modalities, with an emphasis on the use of radioiodine and the importance of post treatment monitoring of thyroid and renal parameters. In Australia, a common curative treatment for cats with benign hyperthyroidism (i.e. thyroid hyperplasia or adenoma) is a fixed dose of orally administered radioiodine, regardless of the serum total thyroxine concentration at the time of diagnosis. This review discusses the long term outcomes of this standard of care in comparison with current, relevant research literature from around the world. Finally, this review explores the use of symmetric dimethylarginine (SDMA) in assessing renal function before and after treatment in hyperthyroid cats. SDMA correlates well with GFR and creatinine in non-hyperthyroid cats, but our understanding of its performance in hyperthyroid cats remains in its infancy.
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Affiliation(s)
- L Yu
- Veterinary Referral HospitalDandenongVictoriaAustralia
| | - L Lacorcia
- Veterinary Referral HospitalDandenongVictoriaAustralia
| | - T Johnstone
- Animal Referral Hospital, Essendon Fields72 Hargrave AvenueEssendon FieldsVictoria3041Australia
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Grelová S, Karasová M, Tóthová C, Kisková T, Baranová D, Lukáč B, Fialkovičová M, Micháľová A, Kunay L, Svoboda M. Relationship between FGF 23, SDMA, Urea, Creatinine and Phosphate in Relation to Feline Chronic Kidney Disease. Animals (Basel) 2022; 12:2247. [PMID: 36077967 PMCID: PMC9454452 DOI: 10.3390/ani12172247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
Chronic kidney disease (CKD) is a common diagnosis in older cats, and its prevalence increases with age. Conventional indirect biomarkers of glomerular filtration rate (GFR) have their limitations, and are not efficient in detecting early decreases in glomerular filtration rate. Recently, symmetric dimethylarginine (SDMA) concentrations have been proposed as a novel biomarker of GFR for the early detection of CKD. This study discusses the relationship between SDMA, FGF 23 and previously used indicators of kidney function, mainly creatinine, urea and phosphate. Ninety-nine cats were included in this study. Based on their SDMA values, 48 cats had CKD and the remaining 51 cats were used as a healthy control group. Serum of these cats was assayed for creatinine, urea and phosphate concentrations as well as FGF 23 values, and correlations between them were evaluated. Cats with CKD had higher FGF 23 concentrations than healthy cats, and no correlation was found between FGF 23 and SDMA, nor between FGF 23 and phosphate. On the other hand, phosphate strongly correlated with SDMA, urea and creatinine, making it a possible independent factor of CKD progression.
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Affiliation(s)
- Simona Grelová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Martina Karasová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Csilla Tóthová
- Clinic of Ruminants, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Terézia Kisková
- Faculty of Science, University of Pavol Jozef Šafárik, 04154 Košice, Slovakia
| | - Darina Baranová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Branislav Lukáč
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Mária Fialkovičová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Alena Micháľová
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Lukáš Kunay
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
| | - Miroslav Svoboda
- Small Animal Clinic, University of Veterinary Medicine and Pharmacy, 04001 Košice, Slovakia
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16
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Loane SC, Thomson JM, Williams TL, McCallum KE. Evaluation of symmetric dimethylarginine in cats with acute kidney injury and chronic kidney disease. J Vet Intern Med 2022; 36:1669-1676. [PMID: 35903963 PMCID: PMC9511064 DOI: 10.1111/jvim.16497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/07/2022] [Indexed: 11/26/2022] Open
Abstract
Background Serum symmetric dimethylarginine (SDMA) concentrations are considered a biomarker for renal dysfunction in dogs and humans with acute kidney injury (AKI). No studies have assessed SDMA in cats with AKI. Hypothesis/Objectives SDMA correctly identifies cats with azotemic AKI. Animals Fifteen control cats, 22 with novel AKI, 13 with acute on chronic‐AKI (AoC) and 19 with chronic kidney disease (CKD). Methods Retrospective study. Cats with azotemia (serum creatinine concentrations >1.7 mg/dL) were defined as having AKI or CKD based on history, clinical signs, clinicopathological findings and diagnostic imaging, and classified using the International Renal Interest Society (IRIS) grading/staging systems. Serum SDMA concentrations were compared between groups with nonparametric methods, and correlations assessed using Spearman's correlation coefficient. Data are presented as median [range]. Results SDMA concentrations were 11 (8‐21) μg/dL, 36 (9‐170)μg/dL, 33 (22‐75) μg/dL and 25 (12‐69) μg/dL in control, novel AKI, AoC and CKD cats. SDMA concentrations were significantly higher in cats with novel AKI (P < .001), AoC (P < .001) and CKD (P < .01) compared to controls. SDMA concentrations were significantly higher in cats with more advanced AKI (IRIS grade IV‐V) compared to less severe AKI (IRIS grade II). Serum creatinine and SDMA concentrations had a significant correlation in cats with novel AKI (rs = 0.826, n = 22; P < .001) and a significant correlation when all cats across all 4 groups were considered together (rs = 0.837, n = 69; P < .001). Conclusions and Clinical Importance Serum SDMA concentrations are elevated in cats with established AKI (novel and AoC) and CKD, providing evidence for use of SDMA as a biomarker for AKI in cats.
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Affiliation(s)
- Samantha C Loane
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - James M Thomson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Timothy L Williams
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Katie E McCallum
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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Andrews BJ, Cushing AC, Murphy RE, Wilson EM, Sula MJM. Blood concentration of symmetric dimethylarginine correlates with kidney damage as assessed with a proposed histologic grading system for chronic kidney disease in tigers (Panthera tigris). J Am Vet Med Assoc 2022; 260:1-8. [PMID: 35417415 DOI: 10.2460/javma.21.04.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the utility of blood symmetric dimethylarginine (SDMA) concentration measurement as a diagnostic tool for chronic kidney disease (CKD) in tigers (Panthera tigris) by comparing results for SDMA with those for traditional renal biomarkers and investigating correlations between these biomarkers and histopathologic kidney changes in tigers with CKD. SAMPLE Blood, urine, and kidney samples from 35 tigers with CKD from 2 sanctuaries. PROCEDURES Blood (serum or plasma) and urine samples were collected antemortem. Necropsy, including gross and histologic assessment, was performed for tigers that died or were euthanized for quality-of-life reasons. Results for CKD biomarkers in blood (BUN, creatinine, phosphorus, and SDMA concentrations) and urine (protein concentration, urine protein-to-creatinine ratio, and urine specific gravity) were evaluated for correlation with histologic kidney damage scored with an objective grading scale defined by percentage of inflammation, fibrosis, and tubular atrophy. RESULTS Symmetric dimethylarginine had the strongest significant correlation (ρ = 0.667) with histologic kidney damage score, followed by urine specific gravity (ρ = -0.639), blood creatinine concentration (ρ = 0.624), and BUN (ρ = 0.588). No significant correlation with kidney score was identified for blood phosphorus concentration, urine protein concentration, or the urine protein-to-creatinine ratio. CLINICAL RELEVANCE We recommend SDMA be prioritized as a renal biomarker in tigers, with SDMA results considered in addition to those of other traditional renal biomarkers when assessing kidney function in tigers. Additionally, the grading scale we developed could be replicated across patients and pathologists for more consistent postmortem assessment of CKD in tigers.
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Affiliation(s)
- Blake J Andrews
- Mr. Andrews was a third-year veterinary student at the College of Veterinary Medicine, University of Tennessee, Knoxville, TN, when the report was written
| | - Andrew C Cushing
- 1Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN
| | | | - Emily M Wilson
- 3In-Sync Exotics Wildlife Rescue & Educational Center, Wylie, TX
| | - Mee-Ja M Sula
- 4Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN
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18
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Michael H, Szlosek D, Clements C, Mack R. Symmetrical Dimethylarginine: Evaluating Chronic Kidney Disease in the Era of Multiple Kidney Biomarkers. Vet Clin North Am Small Anim Pract 2022; 52:609-629. [DOI: 10.1016/j.cvsm.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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Kongtasai T, Paepe D, Meyer E, Mortier F, Marynissen S, Stammeleer L, Defauw P, Daminet S. Renal biomarkers in cats: A review of the current status in chronic kidney disease. J Vet Intern Med 2022; 36:379-396. [PMID: 35218249 PMCID: PMC8965260 DOI: 10.1111/jvim.16377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 12/22/2022] Open
Abstract
Serum creatinine concentration, the classical biomarker of chronic kidney disease (CKD) in cats, has important limitations that decrease its value as a biomarker of early CKD. Recently, serum symmetric dimethylarginine concentration was introduced as a novel glomerular filtration rate biomarker for the early detection of CKD in cats. However, data on its specificity are still limited. The limitations of conventional biomarkers and the desire for early therapeutic intervention in cats with CKD to improve outcomes have prompted the discovery and validation of novel renal biomarkers to detect glomerular or tubular dysfunction. Changes in the serum or urinary concentrations of these biomarkers may indicate early kidney damage or predict the progression of kidney before changes in conventional biomarkers are detectable. This review summarizes current knowledge on renal biomarkers in CKD in cats, a field that has progressed substantially over the last 5 years.
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Affiliation(s)
- Thirawut Kongtasai
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium.,Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Dominique Paepe
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium
| | - Evelyne Meyer
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Femke Mortier
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium
| | - Sofie Marynissen
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium
| | - Lisa Stammeleer
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium
| | - Pieter Defauw
- Lumbry Park Veterinary Specialists, Alton, United Kingdom
| | - Sylvie Daminet
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium
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Krasztel MM, Czopowicz M, Szaluś-Jordanow O, Moroz A, Mickiewicz M, Kaba J. Correlation between metabolomic profile constituents and feline pancreatic lipase immunoreactivity. J Vet Intern Med 2022; 36:473-481. [PMID: 35023223 PMCID: PMC8965226 DOI: 10.1111/jvim.16349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Feline pancreatic lipase immunoreactivity (fPLI) is commonly used to diagnose pancreatitis in cats (FP). Untargeted metabolomics has been extensively applied in human and veterinary medicine, but no metabolomic studies regarding FP have been conducted. Objectives To identify metabolites significantly associated with increased fPLI. Animals Forty‐nine client‐owned cats: 11 clinically healthy and 38 with various clinical conditions. Methods Analytical cross‐sectional study with convenience sampling. A panel of 630 metabolites belonging to 26 biochemical classes was quantified in plasma using a commercial metabolomic assay. The correlation between plasma metabolite concentrations and serum fPLI was evaluated using Spearman's rank correlation coefficient (Rs) with Bonferroni correction. Multivariable analysis then was performed to control for glomerular filtration rate, liver damage, and blood glucose concentration. The accuracy of selected metabolites in discriminating between cats with normal (≤3.5 μg/L) and increased (>5.3 μg/L) fPLI was estimated using the area under the receiver operating characteristic curve (AUROC). Results Four hundred and seven of 630 metabolites (64.6%) were quantified in all cats. When controlled for potential confounders only 3 sphingolipids were significantly positively correlated with fPLI: 2 cerebrosides: HexCer(d18:1/24:0); (Rs = .56), and HexCer(d18:1/24:1); (Rs = .58) and 1 sphingomyelin: SM C18:0 (Rs = .55). Their AUROCs in identifying cats with increased fPLI were 82% (95% confidence interval [CI 95%], 70%‐94%), 84% (CI 95%, 72%‐96%), and 78% (CI 95%, 65%‐92%), respectively. Conclusions and Clinical Importance Selected sphingolipids are moderately positively correlated with fPLI and appear to have fair to moderate diagnostic accuracy in discriminating between cats with normal and increased fPLI.
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Affiliation(s)
- Magdalena Maria Krasztel
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Michał Czopowicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Olga Szaluś-Jordanow
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Agata Moroz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Marcin Mickiewicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Jarosław Kaba
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
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Coltherd JC, Alexander JE, Pink C, Rawlings J, Elliott J, Haydock R, Carvell-Miller LJ, Biourge VC, Molina L, Butterwick R, Logan DW, Watson P, Bakke AM. Towards establishing no observed adverse effect levels (NOAEL) for different sources of dietary phosphorus in feline adult diets: results from a 7-month feeding study. Br J Nutr 2021; 126:1626-1641. [PMID: 33550999 DOI: 10.1017/s0007114521000477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
High dietary phosphorus (P), particularly soluble salts, may contribute to chronic kidney disease development in cats. The aim of the present study was to assess the safety of P supplied at 1 g/1000 kcal (4184kJ) from a highly soluble P salt in P-rich dry format feline diets. Seventy-five healthy adult cats (n 25/group) were fed either a low P control (1·4 g/1000 kcal [4184kJ]; Ca:P ratio 0·97) or one of two test diets with 4 g/1000 kcal (4184 kJ); Ca:P 1·04 or 5 g/1000 kcal (4184kJ); Ca:P 1·27, both incorporating 1 g/1000 kcal (4184 kJ) sodium tripolyphosphate (STPP) - for a period of 30 weeks in a randomised parallel-group study. Health markers in blood and urine, glomerular filtration rate, renal ultrasound and bone density were assessed at baseline and at regular time points. At the end of the test period, responses following transition to a commercial diet (total P - 2·34 g/1000 kcal [4184kJ], Ca:P 1·3) for a 4-week washout period were also assessed. No adverse effects on general, kidney or bone (skeletal) function and health were observed. P and Ca balance, some serum biochemistry parameters and regulatory hormones were increased in cats fed test diets from week 2 onwards (P ≤ 0·05). Data from the washout period suggest that increased serum creatinine and urea values observed in the two test diet groups were influenced by dietary differences during the test period, and not indicative of changes in renal function. The present data suggest no observed adverse effect level for feline diets containing 1 g P/1000 kcal (4184 kJ) from STPP and total P level of up to 5 g/1000 kcal (4184 kJ) when fed for 30 weeks.
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Affiliation(s)
- Jennifer C Coltherd
- Waltham Petcare Science Institute, Melton Mowbray, LeicestershireLE14 4RT, UK
| | - Janet E Alexander
- Waltham Petcare Science Institute, Melton Mowbray, LeicestershireLE14 4RT, UK
| | - Claire Pink
- Waltham Petcare Science Institute, Melton Mowbray, LeicestershireLE14 4RT, UK
| | - John Rawlings
- Waltham Petcare Science Institute, Melton Mowbray, LeicestershireLE14 4RT, UK
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, LondonNW1 0TU, UK
| | - Richard Haydock
- Waltham Petcare Science Institute, Melton Mowbray, LeicestershireLE14 4RT, UK
| | | | | | | | - Richard Butterwick
- Waltham Petcare Science Institute, Melton Mowbray, LeicestershireLE14 4RT, UK
| | - Darren W Logan
- Waltham Petcare Science Institute, Melton Mowbray, LeicestershireLE14 4RT, UK
| | - Phillip Watson
- Waltham Petcare Science Institute, Melton Mowbray, LeicestershireLE14 4RT, UK
| | - Anne Marie Bakke
- Waltham Petcare Science Institute, Melton Mowbray, LeicestershireLE14 4RT, UK
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Mack RM, Hegarty E, McCrann DJ, Michael HT, Grauer GF. Longitudinal evaluation of symmetric dimethylarginine and concordance of kidney biomarkers in cats and dogs. Vet J 2021; 276:105732. [PMID: 34391920 DOI: 10.1016/j.tvjl.2021.105732] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/21/2021] [Accepted: 08/10/2021] [Indexed: 01/01/2023]
Abstract
Symmetric dimethylarginine (SDMA) is a sensitive surrogate marker for glomerular filtration rate; however, there are uncertainties as to how to interpret mild increases (SDMA 15-19 μg/dL). This descriptive study used retrospective data to evaluate whether cats or dogs that had initial SDMA values (at T0) within the reference interval followed by an increased SDMA (at T1) had persistently increased SDMA (at T2; measured from 14 days to 18 months following T1; Persistence Cohort), and if and when cats or dogs with persistently increased SDMA had increased creatinine up to 24 months (Concordance Cohort). The Persistence Cohort included 16,670 cats and 16,712 dogs. If SDMA at T1 was 15-19 μg/dL, the probability of persistence was 53% for cats and 42% for dogs, while creatinine was concurrently increased in 20% of cats and 18% of dogs. For comparison, if SDMA was not increased at T1 the probability of increased SDMA at recheck was only 20% for cats and 9% for dogs. For cats and dogs with a T1 SDMA of 15-19 μg/dL and with persistent increases at T2, the probability of increased creatinine at T1 was 20% for cats and 18% for dogs, rising to 61% and 55%, respectively, by 24 months. When SDMA at T1 was >25 μg/dL, creatinine was increased in 93% of cats and 92% of dogs by 24 months. Mildly increased SDMA results may provide an opportunity to identify some cats and dogs earlier in their kidney disease.
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Affiliation(s)
- R M Mack
- IDEXX, 1 IDEXX Drive, Westbrook, ME 04092, USA.
| | - E Hegarty
- IDEXX, 1 IDEXX Drive, Westbrook, ME 04092, USA
| | - D J McCrann
- IDEXX, 1 IDEXX Drive, Westbrook, ME 04092, USA
| | - H T Michael
- IDEXX, 1 IDEXX Drive, Westbrook, ME 04092, USA
| | - G F Grauer
- College of Veterinary Medicine, Kansas State University, A-111 Mosier Hall, Manhattan, KS 66506-5802, USA
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Granick M, Leuin AS, Trepanier LA. Plasma and urinary F 2-isoprostane markers of oxidative stress are increased in cats with early (stage 1) chronic kidney disease. J Feline Med Surg 2021; 23:692-699. [PMID: 33146574 PMCID: PMC10812189 DOI: 10.1177/1098612x20969358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Oxidative stress contributes to chronic kidney disease (CKD) progression in humans and rodent models; F2-isoprostanes (F2-IsoPs) are established biomarkers of oxidative stress. Our primary aim was to evaluate plasma F2-IsoPs in cats with International Renal Interest Society stage 1 and 2 CKD, compared with healthy cats, and to determine whether plasma and urinary F2-IsoPs are equivalent biomarkers. The secondary aim was to assess whether consumption of a renal diet enriched in omega-3 fatty acids led to improvements in plasma and urinary F2-IsoPs. METHODS Plasma and urinary F2-IsoPs were measured in 24 cats with stage 1 or 2 CKD, and 12 unaffected controls aged ⩾6 years. Twelve CKD cats were re-evaluated after feeding a commercial renal diet for at least 4 weeks. RESULTS Median plasma F2-IsoPs were significantly higher in stage 1 CKD (96.2 pg/ml), early stage 2 CKD (83.2 pg/ml) and late stage 2 CKD (80.8 pg/ml) compared with healthy cats (22.8 pg/ml; P = 0.03-0.002). Median urinary F2-IsoPs were significantly higher in cats with stage 1 CKD (231.2 pg/mg) compared with healthy cats (152.5 pg/mg) or cats with late stage 2 CKD (124.8 pg/mg; P = 0.01). Plasma F2-IsoPs remained increased, while urinary F2-IsoPs fell with transition from stage 1 to stage 2 CKD. Feeding a commercial renal diet led to significant decreases in plasma F2-IsoPs in the small group of cats with stage 1 CKD (25-75% decrease) compared with cats with stage 2 CKD (20% decrease to 53% increase; P = 0.01). CONCLUSIONS AND RELEVANCE Oxidative stress is prominent in cats with stage 1 CKD. Plasma and urinary F2-IsoPs are not interchangeable biomarkers in cats with stage 2 CKD. Placebo-controlled studies are indicated to evaluate dietary or pharmacologic doses of omega-3 fatty acids on redox stress and progression of renal dysfunction in cats with stage 1 CKD.
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Affiliation(s)
- Martin Granick
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI, USA
| | - Allison S Leuin
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI, USA
| | - Lauren A Trepanier
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin–Madison, Madison, WI, USA
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COMPARISON OF BLOOD SYMMETRIC DIMETHYLARGININE AND CREATININE AS ENDOGENOUS MARKERS OF KIDNEY FUNCTION IN CAPTIVE TIGERS ( PANTHERA TIGRIS). J Zoo Wildl Med 2021; 52:628-637. [PMID: 34130406 DOI: 10.1638/2020-0032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 11/21/2022] Open
Abstract
Chronic kidney disease (CKD) is a common cause of morbidity and mortality in captive tigers (Panthera tigris). Blood creatinine (Cr) and blood urea nitrogen measurements are inexpensive and common biomarkers used to evaluate renal function. However, several limitations have been reported regarding their sensitivity and interindividual variability. Symmetric dimethylarginine (SDMA) has been suggested to be a more sensitive biomarker that is less affected by extrarenal factors and has a strong correlation with glomerular filtration rate and blood Cr in several species. This project aimed to identify the usefulness of SDMA as an endogenous marker of kidney function in captive tigers. The hypothesis of this study is that increased circulating SDMA is positively associated with increased blood Cr. SDMA and Cr were measured in 65 banked samples (serum and plasma) from 30 individual captive tigers. The samples were collected over a 38-y period and stored at -21°C. SDMA and Cr concentrations were determined using the commercially available SDMA test and enzymatic colorimetric methods, respectively. SDMA had a significant positive association with Cr (for every 1 unit increase of log SDMA, Cr increased by 82%, P = 0.0002). Age and subspecies influenced Cr but not SDMA concentrations. In one animal, blood SDMA increased above the ZIMS reported range. approximately 3.6 mo before Cr increased. SDMA is currently indicated for the diagnosis of CKD in domestic felids and seems also promising in nondomestic felids. Further prospective studies might improve the understanding of the performance of this biomarker.
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Serum Symmetric Dimethylarginine Concentration in Greyhound Pups and Adults. Top Companion Anim Med 2021; 45:100558. [PMID: 34246821 DOI: 10.1016/j.tcam.2021.100558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/23/2021] [Accepted: 07/06/2021] [Indexed: 11/23/2022]
Abstract
Greyhounds have developed numerous physiologic and hematologic adaptations specific to the breed. Adult Greyhounds have significantly higher serum creatinine (sCr) concentrations than non-Greyhound dogs; this is primarily attributed to their large muscle mass. Adult Greyhounds also have significantly higher symmetric dimethylarginine (SDMA) concentrations than non-Greyhound dogs. In this study we evaluated serum SDMA and sCr concentrations in 48 Greyhound pups from 11 litters, with no exposure to racing, in order to determine if the higher SDMA or sCr concentration in adults is a breed-related trait or is associated with extra-physiological causes (e.g., racing environment, drug administration, etc.). The distribution of SDMA concentration for all the pups (mean: 0.70 µmol/L; 95% CI: 0.70-0.74 µmol/L) was not statistically different from that found in a group of 183 adult Greyhounds; whereas, distribution of sCr concentration in the pups (mean: 76.9 µmol/L; 95% CI: 70.7-83.1 µmol/L) was significantly different than that observed in adult Greyhounds, suggesting that the 2 samples were drawn from different populations. This study provides evidence to support that the higher serum SDMA concentration in Greyhounds is a breed-related trait.
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Updates on Laboratory Evaluation of Feline Cardiac Diseases. Vet Sci 2021; 8:vetsci8030041. [PMID: 33802401 PMCID: PMC8000286 DOI: 10.3390/vetsci8030041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/15/2021] [Accepted: 02/26/2021] [Indexed: 11/17/2022] Open
Abstract
Laboratory tests can be altered in cardiovascular diseases and the investigation of specific tests or biomarkers may provide additional information about myocardial damage. Traditional laboratory tests, such as cell blood count, serum biochemistry, and coagulation, can be useful in investigating patients, but are not specific. However, markers like Troponin and Natriuretic Peptides may possibly furnish further data on myocardium damage and can be used in both studying and monitoring cats with cardiac disease. Moreover, the evaluation of the thyroid profile is very important as hyperthyroid cats concomitant cardiovascular diseases are very common and they can also be a direct consequence of endocrinopathy. The purpose of this manuscript is to provide the widest possible overview of what is present in the literature about the feline clinical pathology of heart diseases through a rational division of the main alterations of traditional tests and biomarkers.
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Obert LA, Elmore SA, Ennulat D, Frazier KS. A Review of Specific Biomarkers of Chronic Renal Injury and Their Potential Application in Nonclinical Safety Assessment Studies. Toxicol Pathol 2021; 49:996-1023. [PMID: 33576319 DOI: 10.1177/0192623320985045] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A host of novel renal biomarkers have been developed over the past few decades which have enhanced monitoring of renal disease and drug-induced kidney injury in both preclinical studies and in humans. Since chronic kidney disease (CKD) and acute kidney injury (AKI) share similar underlying mechanisms and the tubulointerstitial compartment has a functional role in the progression of CKD, urinary biomarkers of AKI may provide predictive information in chronic renal disease. Numerous studies have explored whether the recent AKI biomarkers could improve upon the standard clinical biomarkers, estimated glomerular filtration rate (eGFR), and urinary albumin to creatinine ratio, for predicting outcomes in CKD patients. This review is an introduction to alternative assays that can be utilized in chronic (>3 months duration) nonclinical safety studies to provide information on renal dysfunction and to demonstrate specific situations where these assays could be utilized in nonclinical drug development. Novel biomarkers such as symmetrical dimethyl arginine, dickkopf homolog 3, and cystatin C predict chronic renal injury in animals, act as surrogates for GFR, and may predict changes in GFR in patients over time, ultimately providing a bridge from preclinical to clinical renal monitoring.
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Affiliation(s)
- Leslie A Obert
- 549350GlaxoSmithKline (GSK), Nonclinical Safety, Collegeville, PA, USA
| | - Susan A Elmore
- Cellular and Molecular Pathology Branch, National Toxicology Program (NTP), 6857National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Daniela Ennulat
- 549350GlaxoSmithKline (GSK), Nonclinical Safety, Collegeville, PA, USA
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Baral RM, Freeman KP, Flatland B. Comparison of serum and plasma SDMA measured with point-of-care and reference laboratory analysers: implications for interpretation of SDMA in cats. J Feline Med Surg 2021; 23:906-920. [PMID: 33544013 DOI: 10.1177/1098612x20983260] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Symmetric dimethylarginine (SDMA) reflects the glomerular filtration rate (GFR) in people, dogs and cats. Initial assays used a liquid chromatography-mass spectroscopy (LC-MS) technique. A veterinary immunoassay has been developed for use in commercial laboratories and point-of-care (POC) laboratory equipment. This study sought to: determine POC and commercial laboratory (CL) SDMA assay imprecision; determine any bias of the POC assay compared with the CL assay; calculate observed total error of the POC assay and compare with analytical performance goals; and calculate dispersion and sigma metrics (σ) for POC and CL SDMA methods. METHODS Two separate studies were performed that assessed: (1) imprecision, determined by evaluation of pooled feline plasma or serum; and (2) bias, assessed by comparing pooled plasma and serum results, as well as paired analyses of clinical samples from a single venepuncture measured using both analysers. Results were assessed in relation to performance goals. Dispersion and σ were calculated for both analysers. RESULTS Bias between CL and POC analysers was consistent and high numbers of clinical results were outside performance goals across both studies. Imprecision was poor for both analysers for study 1 and improved to within quality goals for the CL analyser for study 2. Dispersion was at least 40%, meaning a measured result of 14 μg/dl represents a range of possible results from 8 μg/dl to 20 μg/dl. CONCLUSIONS AND RELEVANCE Clinicians should be careful ascribing medical significance to small changes in SDMA concentration, as these may reflect analytical and biological variability. Analyser-specific reference intervals are likely required.
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Affiliation(s)
| | | | - Bente Flatland
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
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Baral RM, Freeman KP, Flatland B. Analytical quality performance goals for symmetric dimethylarginine in cats. Vet Clin Pathol 2021; 50:57-61. [PMID: 33524207 DOI: 10.1111/vcp.12951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/17/2020] [Accepted: 07/22/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Symmetric dimethylarginine (SDMA) reflects the glomerular filtration rate (GFR) in people, dogs, and cats. Initial assays used a liquid chromatography-mass spectroscopy (LC) technique. A veterinary immunoassay has been developed for use in commercial laboratories and point-of-care (POC) laboratory equipment. There have been no independent assessments of these assays, and analytical performance goals for SDMA testing have not been defined. OBJECTIVES This study sought to establish analytical performance goals for SDMA in cats from (a) biological variation (BV) data and (b) expert opinion. METHODS Analytical performance goals were determined from a prior BV study of SDMA in cats and a survey of veterinary internists who have used SDMA in practice. RESULTS Biological variation-based performance goals included an imprecision of ±10% (immunoassay and LC), bias of ±8% (immunoassay and LC), and total error of ±24% (immunoassay and LC). Expert opinion performance goals were ±0.10 μmol/L (±2 μg/dL), or ±0.15 μmol/L (±3 μg/dL), varying with starting SDMA concentrations. CONCLUSIONS This study recommends analytical performance goals for SDMA based on BV and expert opinion. Wide dispersion of SDMA results using currently available assays implies that clinicians risk attaching medical significance to small SDMA changes that actually reflect analytical variability.
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Affiliation(s)
| | | | - Bente Flatland
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
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Tang PK, Geddes RF, Chang YM, Jepson RE, Bijsmans E, Elliott J. Risk factors associated with disturbances of calcium homeostasis after initiation of a phosphate-restricted diet in cats with chronic kidney disease. J Vet Intern Med 2020; 35:321-332. [PMID: 33368694 PMCID: PMC7848342 DOI: 10.1111/jvim.15996] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Dietary phosphate restriction improves survival in cats with chronic kidney disease (CKD). However, feeding a phosphate-restricted diet may disrupt calcium homeostasis leading to hypercalcemia in some cats. OBJECTIVES To identify risk factors associated with increasing plasma total calcium (tCa) concentration after transition to a phosphate-restricted diet and to explore its role in CKD-mineral and bone disorder (CKD-MBD) in cats. ANIMALS Seventy-one geriatric (≥9 years) euthyroid client-owned cats with International Renal Interest Society (IRIS) stage 2 to 3 azotemic CKD. METHODS Retrospective cross-sectional cohort study. Changes in plasma tCa concentration in the first 200 days of diet transition were assessed using linear regression. Binary logistic regressions were performed to identify risk factors for increasing calcium concentration. Changes in clinicopathological variables associated with CKD-MBD over time were explored using linear mixed model and generalized linear mixed model analyses. RESULTS Lower baseline plasma potassium (odds ratio [OR] = 1.19 per 0.1 mmol/L decrease; P = .003) and phosphate (OR = 1.15 per 0.1 mmol/L decrease; P = .01) concentrations remained independent risk factors for increasing plasma tCa concentration. Plasma creatinine (β = .069 ± .029 mg/dL; P = .02), symmetric dimethylarginine (β = .64 ± .29 μg/dL; P = .03), phosphate (β = .129 ± .062 mg/dL; P = .04), and ln[FGF23] (β = .103 ± .035 pg/mL; P = .004) concentrations had significantly increased rates of change in cats with increasing plasma tCa concentration over time. CONCLUSION AND CLINICAL IMPORTANCE Lower plasma potassium or phosphate concentrations or both at the time of transition of cats with CKD to a phosphate-restricted diet are independently associated with increased risk of an increase in plasma tCa concentration. Increasing plasma tCa concentration is associated with progression of CKD.
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Affiliation(s)
- Pak-Kan Tang
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - Rebecca F Geddes
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
| | - Yu-Mei Chang
- Research Support Office, Royal Veterinary College, University of London, London, UK
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
| | | | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
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31
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Brans M, Daminet S, Mortier F, Duchateau L, Lefebvre HP, Paepe D. Plasma symmetric dimethylarginine and creatinine concentrations and glomerular filtration rate in cats with normal and decreased renal function. J Vet Intern Med 2020; 35:303-311. [PMID: 33274800 PMCID: PMC7848354 DOI: 10.1111/jvim.15975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 11/05/2020] [Accepted: 11/12/2020] [Indexed: 12/30/2022] Open
Abstract
Background Glomerular filtration rate (GFR) is the gold standard in assessing renal function but is impractical. Serum creatinine (sCr) has limited sensitivity in identifying early chronic kidney disease (CKD), whereas symmetric dimethylarginine (SDMA) has been commercialized as more accurate biomarker. Studies comparing SDMA and sCr with GFR in cats are limited. Objectives To further investigate the diagnostic performance of SDMA in nonazotemic and azotemic cats. Animals Forty‐nine client‐owned cats: 17 cats with CKD, 15 cats with diabetes mellitus (DM), and 17 healthy cats. Methods Retrospective study using spare blood samples from cats with documented sCr and GFR results for SDMA analysis. Diagnostic performances of SDMA and sCr were evaluated using correlation coefficients, sensitivities, specificities, and receiver operator characteristic curves. Results Compared to healthy cats and cats with DM, CKD cats had significantly higher SDMAplasma (26.7 ± 9.9 μg/dL) and sCr (249.7 ± 71.6 μmol/L [2.8 ± 0.8 mg/dL]; both P < .001) values. SDMAplasma (τB = −0.57; P < .001) and sCr (τB = −0.56; P < .001) were significantly correlated with GFR. SDMAplasma (τB = 0.52; P < .001) had a significant relationship with sCr. SDMAplasma and sCr had similar sensitivity (76%‐94% and 71%‐88%, respectively) in detecting reduced renal function. Creatinine had higher specificity (94%‐96%) than SDMAplasma (75%‐76%) (P < .05). Conclusion and Clinical Importance In this study of azotemic and nonazotemic cats, SDMA was a reliable marker to identify decreased GFR. However, superiority of SDMA over sCr could not be confirmed.
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Affiliation(s)
- Marleen Brans
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Sylvie Daminet
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Femke Mortier
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Luc Duchateau
- Department of Nutrition, Genetics and Ethology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Hervé P Lefebvre
- Department of Physiology and Therapeutics, National Veterinary School of Toulouse, Toulouse, France
| | - Dominique Paepe
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Lautz LS, Jeddi MZ, Girolami F, Nebbia C, Dorne JLCM. Metabolism and pharmacokinetics of pharmaceuticals in cats (Felix sylvestris catus) and implications for the risk assessment of feed additives and contaminants. Toxicol Lett 2020; 338:114-127. [PMID: 33253781 DOI: 10.1016/j.toxlet.2020.11.014] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/25/2023]
Abstract
In animal health risk assessment, hazard characterisation of feed additives has been often using the default uncertainty factor (UF) of 100 to translate a no-observed-adverse-effect level in test species (rat, mouse, dog, rabbit) to a 'safe' level of chronic exposure in farm and companion animal species. Historically, both 10-fold factors have been further divided to include chemical-specific data in both dimensions when available. For cats (Felis Sylvestris catus), an extra default UF of 5 is applied due to the species' deficiency in particularly glucuronidation and glycine conjugation. This paper aims to assess the scientific basis and validity of the UF for inter-species differences in kinetics (4.0) and the extra UF applied for cats through a comparison of kinetic parameters between rats and cats for 30 substrates of phase I and phase II metabolism. When the parent compound undergoes glucuronidation the default factor of 4.0 is exceeded, with exceptions for zidovudine and S-carprofen. Compounds that were mainly renally excreted did not exceed the 4.0-fold default. Mixed results were obtained for chemicals which are metabolised by CYP3A in rats. When chemicals were administered intravenously the 4.0-fold default was not exceeded with the exception of clomipramine, lidocaine and alfentanil. The differences seen after oral administration might be due to differences in first-pass metabolism and bioavailability. Further work is needed to further characterise phase I, phase II enzymes and transporters in cats to support the development of databases and in silico models to support hazard characterisation of chemicals particularly for feed additives.
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Affiliation(s)
- L S Lautz
- Radboud University Nijmegen, Houtlaan 4, 6525 XZ Nijmegen, the Netherlands
| | - M Z Jeddi
- European Food Safety Authority, Scientific Committee and Emerging Risks Unit, Via Carlo Magno, 1A, 43126 Parma, Italy
| | - F Girolami
- University of Torino, Department of Veterinary Sciences, Largo P. Braccini 2, 10095 Grugliasco, Italy
| | - C Nebbia
- University of Torino, Department of Veterinary Sciences, Largo P. Braccini 2, 10095 Grugliasco, Italy
| | - J L C M Dorne
- European Food Safety Authority, Scientific Committee and Emerging Risks Unit, Via Carlo Magno, 1A, 43126 Parma, Italy.
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Sargent HJ, Elliott J, Jepson RE. The new age of renal biomarkers: does SDMA solve all of our problems? J Small Anim Pract 2020; 62:71-81. [PMID: 33184865 DOI: 10.1111/jsap.13236] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 05/15/2020] [Accepted: 09/15/2020] [Indexed: 12/28/2022]
Abstract
Within clinical small animal practice, diagnosis of both chronic kidney disease and acute kidney injury is common. To assess renal function, measurement of glomerular filtration rate is considered the gold standard. Currently, routine tests of kidney function include surrogate markers of glomerular filtration rate such as serum creatinine, and urea, each with their own limitations, whilst urine protein to creatinine ratio gives an indication of glomerular and tubular handling of protein, and urine specific gravity information about urine concentrating ability by the kidney. These parameters are used together with historical and physical examination data to give a diagnosis of kidney disease following which creatinine, proteinuria and blood pressure are used to stage chronic kidney disease and, together with urine output, grade acute kidney injury according to the International Renal Interest Society. However, there has been much concern that creatinine is insensitive when used to indicate early decline in renal function and this has highlighted the need for additional methods of diagnosing and monitoring these patients, with the potential to allow earlier therapeutic intervention. Symmetric dimethylarginine is a novel biomarker, which has been shown to perform as a surrogate marker of glomerular filtration rate in small animals. This article will review current research on symmetric dimethylarginine and the ways in which it may be utilised in small animal practice; current research supports the use of symmetric dimethylarginine as a screening test for detection of early chronic kidney disease according to International Renal Interest Society guidelines, but further research is required in to the usefulness of symmetric dimethylarginine as a tool for monitoring disease and the effect of non-renal influences.
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Affiliation(s)
- H J Sargent
- Royal Veterinary College, North Mymms, Herts, AL9 7TA, UK
| | - J Elliott
- Royal Veterinary College, North Mymms, Herts, AL9 7TA, UK
| | - R E Jepson
- Royal Veterinary College, North Mymms, Herts, AL9 7TA, UK
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Siwinska N, Zak A, Slowikowska M, Niedzwiedz A, Paslawska U. Serum symmetric dimethylarginine concentration in healthy horses and horses with acute kidney injury. BMC Vet Res 2020; 16:396. [PMID: 33081772 PMCID: PMC7576750 DOI: 10.1186/s12917-020-02621-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 10/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There are limited options to diagnose acute kidney injury (AKI) in horses. Symmetric dimethylarginine (SDMA) is routinely used in human and small animal medicine. The aim of this study was to assess serum SDMA concentrations in healthy horses and horses with AKI. The objective of this study was to evaluate the association of: 1) age, 2) sex, 3) body weight and 4) serum creatinine and urea levels on serum SDMA concentrations. Fifty-three healthy horses, including 17 foals (2-6 months of age) and 36 adult horses (3-29 years of age), and 23 horses with AKI were included in the study based on history, physical examination, blood analysis, urinalysis and an ultrasonographic examination of the urinary tract. Serum SDMA concentrations were measured using a non-species specific commercial ELISA test. RESULTS In healthy adult horses, the value of SDMA was 0.53 ± 0.14 μmol/L. The value was higher in foals (1.5 ± 0.4 μmol/L, P < 0.001). Horses with AKI had significantly higher concentrations of SDMA compared to healthy horses (1.76 ± 1.05 μmol/L, P < 0.001). In the healthy adult horses, there was no association of sex, age or body weight on SDMA. However, a significant positive relationship was found between serum creatinine and SDMA concentrations. CONCLUSIONS Healthy adult horses had SDMA values similar to those of other species. Foals had higher SDMA values. Therefore, different reference values should be created for them. The study confirmed an increased SDMA in horses with AKI. This, as well as the low influence of extrarenal factors on the SDMA values, may confirm its usefulness in the diagnosis of kidney dysfunction. Higher SDMA values may also indicate a more advanced degree of kidney dysfunction. Further research is required to determine whether SDMA could be used to detect kidney dysfunction in the asymptomatic stage of AKI.
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Affiliation(s)
- Natalia Siwinska
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
| | - Agnieszka Zak
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
| | - Malwina Slowikowska
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
| | - Artur Niedzwiedz
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
| | - Urszula Paslawska
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, C.K. Norwida 25, 50-375 Wroclaw, Poland
- Veterinary Institute, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University Torun ul, Gagarina 7, 87-100 Torun, Torun, Poland
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Di Paola A, Carotenuto G, Dondi F, Corsini A, Corradini S, Fracassi F. Symmetric dimethylarginine concentrations in dogs with hypothyroidism before and after treatement with levothyroxine. J Small Anim Pract 2020; 62:89-96. [PMID: 32926428 DOI: 10.1111/jsap.13212] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the serum symmetric dimethylarginine (SDMA) and serum creatinine concentrations in a population of hypothyroid dogs at the time of diagnosis and after treatment. MATERIALS AND METHODS Serum SDMA and serum creatinine were measured in serum samples of 24 healthy dogs and 24 hypothyroid dogs, at the time of diagnosis (T0) and after supplementation with levothyroxine (T1). RESULTS The mean SDMA concentrations (reference intervals [RI] <18 μg/dL and <14 μg/dL depending on the source) were 11.7 ± 3.5 μg/dL, 13.8 ± 3.1 μg/dL and 11.83 ± 2.87 μg/dL in healthy dogs, and in the hypothyroid dogs at T0 and T1, respectively. The SDMA concentrations were higher in the hypothyroid dogs at T0 in comparison with the healthy dogs. Of the hypothyroid dogs, 1 out of 24 had an SDMA concentration above 18 μg/dL and 12 out of 24 above 14 μg/dL at T0. At T1, none of the hypothyroid dogs had SDMA concentrations above 18 μg/dL and two of them had SDMA concentrations above 14 μg/dL. The serum creatinine concentration was higher in the hypothyroid dogs at T0 as compared to the healthy dogs. At T0, 8 out of 24 hypothyroid dogs had serum creatinine concentrations above the RI (>1.4 mg/dL). In all but one dog, serum creatinine normalised after treatment. CLINICAL SIGNIFICANCE The SDMA and serum creatinine concentrations were higher in hypothyroid dogs at diagnosis as compared to healthy dogs. Serum creatinine concentrations were increased in one-third of the hypothyroid dogs and in the majority of cases normalised after levothyroxine supplementation. SDMA concentrations were rarely above the upper limit of the RI when the higest (<18 μg/dL) cut-off was employed. The diagnostic accuracy of SDMA in dogs with thyroid dysfunction requires additional evaluation.
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Affiliation(s)
- A Di Paola
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
| | - G Carotenuto
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
| | - F Dondi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
| | - A Corsini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
| | - S Corradini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
| | - F Fracassi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40064, Italy
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Biourge V, Delmotte S, Feugier A, Bradley R, McAllister M, Elliott J. An artificial neural network-based model to predict chronic kidney disease in aged cats. J Vet Intern Med 2020; 34:1920-1931. [PMID: 32893924 PMCID: PMC7517863 DOI: 10.1111/jvim.15892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 08/06/2020] [Accepted: 08/18/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) frequently causes death in older cats; its early detection is challenging. OBJECTIVES To build a sensitive and specific model for early prediction of CKD in cats using artificial neural network (ANN) techniques applied to routine health screening data. ANIMALS Data from 218 healthy cats ≥7 years of age screened at the Royal Veterinary College (RVC) were used for model building. Performance was tested using data from 3546 cats in the Banfield Pet Hospital records and an additional 60 RCV cats-all initially without a CKD diagnosis. METHODS Artificial neural network (ANN) modeling used a multilayer feed-forward neural network incorporating a back-propagation algorithm. Clinical variables from single cat visits were selected using factorial discriminant analysis. Independent submodels were built for different prediction time frames. Two decision threshold strategies were investigated. RESULTS Input variables retained were plasma creatinine and blood urea concentrations, and urine specific gravity. For prediction of CKD within 12 months, the model had accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 88%, 87%, 70%, 53%, and 92%, respectively. An alternative decision threshold increased specificity and PPV to 98% and 87%, but decreased sensitivity and NPV to 42% and 79%, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE A model was generated that identified cats in the general population ≥7 years of age that are at risk of developing CKD within 12 months. These individuals can be recommended for further investigation and monitoring more frequently than annually. Predictions were based on single visits using common clinical variables.
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Affiliation(s)
| | | | | | - Richard Bradley
- Waltham Pet Science Institute, Waltham on the Wolds, Leicestershire, United Kingdom
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Coyne M, Szlosek D, Clements C, McCrann D, Olavessen L. Association between breed and renal biomarkers of glomerular filtration rate in dogs. Vet Rec 2020; 187:e82. [PMID: 32611706 PMCID: PMC7799420 DOI: 10.1136/vr.105733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 05/07/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022]
Abstract
Background Kidney disease, especially chronic kidney disease (CKD), is common in older dogs. The biomarkers symmetric dimethylarginine (SDMA) and creatinine (Cr) are indicators of glomerular filtration rate (GFR). This retrospective study used these biomarkers to identify groups at risk of decreased GFR at the breed level. Methods Data from dogs with a single serum chemistry result that included Cr and SDMA submitted between July 2015 through December 2017 were included. Dogs were identified by breed and age group. Decreased GFR was defined as Cr above 1.9 mg/dl or SDMA above 18 µg/dl. Results Fourteen breeds had a significantly higher percentage of dogs with increased SDMA or Cr for one or more age groups. Geriatric and senior Shetland sheepdogs, Yorkshire terriers and Pomeranians were significantly more likely to have increased renal biomarkers. Boxers were identified with significantly increased renal biomarkers in the age groups spanning two months to 10 years of age. Conclusion Evidence of decreased GFR occurred commonly in older dogs of most breeds, especially geriatric dogs greater than 10 years of age, but there were some exceptions, with more significant changes affecting younger animals of several breeds. The combination of SDMA and Cr identified more cases of decreased GFR than either SDMA or Cr alone.
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Affiliation(s)
| | | | | | | | - Lauren Olavessen
- IDEXX Laboratories, Westbrook, Maine, USA.,PetIQ, Eagle, Idaho, United States
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Yu J, Kimble B, Norris JM, Govendir M. Pharmacokinetic Profile of Oral Administration of Mefloquine to Clinically Normal Cats: A Preliminary In-Vivo Study of a Potential Treatment for Feline Infectious Peritonitis (FIP). Animals (Basel) 2020; 10:ani10061000. [PMID: 32521771 PMCID: PMC7341284 DOI: 10.3390/ani10061000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 12/17/2022] Open
Abstract
Simple Summary In searching for antiviral agents against feline coronaviruses and feline caliciviruses, mefloquine, a human anti-malarial drug, has been demonstrated to reduce viral load of feline coronaviruses and feline calicivirus in infected cells. In this study, mefloquine was administered orally to seven clinically healthy cats twice weekly for four doses and mefloquine concentrations in blood were measured to investigate the pharmacokinetic profile—the movement of drug in the body. The maximum blood concentration of mefloquine was 2.71 ug/mL and was reached 15 h after a single oral dose was administered. Mefloquine side effects included vomiting following administration without food in some cats, and mild increases in symmetric dimethylarginine (SDMA), an early kidney biomarker. This study provides valuable information on mefloquine’s profile in cats as an introductory step towards investigating it as a potential treatment for feline coronavirus and feline calicivirus infection in cats. Abstract The pharmacokinetic profile of mefloquine was investigated as a preliminary study towards a potential treatment for feline coronavirus infections (such as feline infectious peritonitis) or feline calicivirus infections. Mefloquine was administered at 62.5 mg orally to seven clinically healthy cats twice weekly for four doses and mefloquine plasma concentrations over 336 h were measured using high pressure liquid chromatography (HPLC). The peak plasma concentration (Cmax) after a single oral dose of mefloquine was 2.71 ug/mL and time to reach Cmax (Tmax) was 15 h. The elimination half-life was 224 h. The plasma concentration reached a higher level at 4.06 ug/mL when mefloquine was administered with food. Adverse effects of dosing included vomiting following administration without food in some cats. Mild increases in serum symmetric dimethylarginine (SDMA), but not creatinine, concentrations were observed. Mefloquine may provide a safe effective treatment for feline coronavirus and feline calicivirus infections in cats.
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Yu L, Lacorcia L, Finch S, Johnstone T. Assessment of serum symmetric dimethylarginine and creatinine concentrations in hyperthyroid cats before and after a fixed dose of orally administered radioiodine. J Vet Intern Med 2020; 34:1423-1431. [PMID: 32506701 PMCID: PMC7379014 DOI: 10.1111/jvim.15831] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/22/2020] [Accepted: 05/22/2020] [Indexed: 12/11/2022] Open
Abstract
Background Serum symmetric dimethylarginine (SDMA) is a sensitive renal biomarker for detecting early chronic kidney disease (CKD) in nonhyperthyroid cats, but knowledge regarding its performance in hyperthyroid cats remains limited. Objectives To determine the relationship between serum SDMA, creatinine and total thyroxine (TT4) concentrations in hyperthyroid cats before (T0) and 3 months after (T1) receiving a PO fixed dose of radioiodine. Animals Eighty client‐owned hyperthyroid cats. Methods Prospective cohort study. Serum TT4, and SDMA, creatinine concentrations, and urine specific gravity were measured at T0 and T1. Nonparametric tests were used to determine the relationship among SDMA, and creatinine and TT4 concentrations. Agreement between SDMA and creatinine regarding CKD staging at both time points was assessed using Goodman and Kruskal's gamma statistic. Results Mean serum SDMA concentration increased after treatment of hyperthyroidism. However, 21 of 75 cats experienced a decrease in SDMA between T0 and T1, whereas creatinine decreased in only 2 cats. A moderate correlation between SDMA and creatinine was seen at T1 (r = 0.53; P < .001) but not at T0 (r = 0.13; P = .25). Where assessable at T1, poor agreement was observed between SDMA and creatinine and CKD stage (Goodman and Kruskal's gamma 0.20; P = .29). Conclusions and clinical importance Discordant outcomes between SDMA and creatinine after radioiodine treatment in cats with hyperthyroidism suggest extrarenal factors may interfere with the reliability of SDMA to adequately reflect renal function. As a result, SDMA should not be interpreted in isolation in hyperthyroid cats treated with radioiodine.
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Affiliation(s)
- Lucia Yu
- Translational Research and Small Animal Clinical Trial Study Group, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Victoria, Australia
| | - Lauren Lacorcia
- Translational Research and Small Animal Clinical Trial Study Group, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Victoria, Australia
| | - Sue Finch
- Statistical Consulting Centre and Melbourne Statistical Consulting Centre, The University of Melbourne, Victoria, Australia
| | - Thurid Johnstone
- Translational Research and Small Animal Clinical Trial Study Group, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Victoria, Australia
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Liu M, Köster LS, Fosgate GT, Chadwick CC, Sanz‐González Í, Eckersall PD, Wotton PR, French AT. Cardiovascular-renal axis disorder and acute-phase proteins in cats with congestive heart failure caused by primary cardiomyopathy. J Vet Intern Med 2020; 34:1078-1090. [PMID: 32395893 PMCID: PMC7255652 DOI: 10.1111/jvim.15757] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/12/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Currently, the pathogenesis of congestive heart failure (CHF) in cats is not fully understood. OBJECTIVE To identify novel biomarkers for CHF in cats caused by primary cardiomyopathy, particularly related to cardiovascular-renal axis disorder and systemic inflammatory response. ANIMALS Twenty-five cats in CHF caused by primary cardiomyopathy, 12 cats with preclinical cardiomyopathy, and 20 healthy controls. METHODS Case control and observational case series. The following serum biomarkers were compared among the 3 cat groups: a cardiorenal profile that included N-terminal pro-brain natriuretic peptide (NT-proBNP), symmetric dimethylarginine (SDMA), and creatinine and an inflammatory profile that included 7 acute-phase proteins (APPs). Survival analyses and longitudinal studies were performed in CHF cats. RESULTS All cardiorenal biomarkers were positively correlated and higher in CHF cats, and high NT-proBNP and SDMA were associated with poor clinical outcome. Cats with CHF had significantly higher leucine-rich alpha-2-glycoprotein 1, serum amyloid A, and ceruloplasmin, and these APPs were positively correlated with NT-proBNP and left atrial size. In a multivariable survival analysis, alpha-1-acid glycoprotein concentration (P = .01), body weight (P = .02) and left atrial-to-aortic root ratio (P = .01) were independent prognostic factors for CHF in these cats. CONCLUSIONS AND CLINICAL IMPORTANCE In cats, CHF is an inflammatory disorder and outcome in CHF may be determined by the extent of inflammation and possibly the amount of residual renal function. These novel biomarkers have potential use for the clinical management, prognosis, and future research into CHF and cardiomyopathy in cats.
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Affiliation(s)
- Mengmeng Liu
- Department of Small Animal Clinical SciencesSmall Animal Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of GlasgowGlasgowUK
| | - Liza S. Köster
- Department of Small Animal Clinical SciencesSmall Animal Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of GlasgowGlasgowUK
- Department of Small Animal Clinical SciencesUniversity of Tennessee, KnoxvilleTennesseeUSA
| | - Geoffrey T. Fosgate
- Faculty of Veterinary Science, Department of Production Animal StudiesUniversity of PretoriaOnderstepoortSouth Africa
| | | | - Íñigo Sanz‐González
- Department of Small Animal Clinical SciencesSmall Animal Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of GlasgowGlasgowUK
| | - Peter David Eckersall
- Institute of Biodiversity, Animal Health and Comparative MedicineUniversity of GlasgowGlasgowUK
| | - Paul R. Wotton
- Department of Small Animal Clinical SciencesSmall Animal Hospital, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of GlasgowGlasgowUK
| | - Anne T. French
- Department of Clinical SciencesRoss University School of Veterinary MedicineBasseterreSt Kitts and Nevis
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Sanchez CR, Hayek LAC, Carlin EP, Brown SA, Citino S, Marker L, Jones KL, Murray S. Glomerular filtration rate determined by measuring serum clearance of a single dose of inulin and serum symmetric dimethylarginine concentration in clinically normal cheetahs ( Acinonyx jubatus). Am J Vet Res 2020; 81:375-380. [DOI: 10.2460/ajvr.81.4.375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Katayama M, Ohata K, Miyazaki T, Katayama R, Wakamatsu N, Ohno M, Yamashita T, Oikawa T, Sugaya T, Miyazaki M. Renal expression and urinary excretion of liver-type fatty acid-binding protein in cats with renal disease. J Vet Intern Med 2020; 34:761-769. [PMID: 32087614 PMCID: PMC7096645 DOI: 10.1111/jvim.15721] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 01/20/2020] [Indexed: 12/26/2022] Open
Abstract
Background Liver‐type fatty acid‐binding protein (L‐FABP) is a biomarker for early detection of renal disease in humans. Liver‐type fatty acid‐binding protein is cytotoxic oxidation products secreted from proximal tubules under ischemia and oxidative stress. Objective To examine renal expression and quantify urinary excretion of L‐FABP in catswith renal disease. Animals One hundred and thirty‐four client‐owned cats including 34 cats with serum creatinine (sCre) values >1.6 mg/dL and 10 other cats that died in clinics. Methods Tissue expressions of L‐FABP were examined by reverse transcription polymerase chain reaction and Western blotting. Urinary L‐FABP (uL‐FABP) and serum L‐FABP (sL‐FABP) levels were determined by enzyme‐linked immunosorbent assay. Anti‐liver‐type fatty acid‐binding protein antibody immunostained renal sections. Results Feline kidneys express L‐FABP. Strong L‐FABP signals were observed in the lumens of proximal tubular cells in 5 cats with high uL‐FABP excretion, but not in 5 cats with low uL‐FABP excretion. In 9 normal cats, uL‐FABP index was <1.2 μg/g urinary creatinine (uCre). High uL‐FABP indexes (>10.0 μg/g uCre) were detected in 7 of 100 cats with low sCre (<1.6 mg/dL) and 18 of 44 cats with high sCre (>1.6 mg/dL). There was a weak correlation between L‐FABP index and sCre, serum symmetric dimethylarginine (SDMA), or blood urea nitrogen (BUN), and these correlation coefficients were increased by analyzing only data of cats with sCre >1.6 mg/dL. There was a weak correlation between u L‐FABP index and sL‐FABP in all tested cats, but not in cats with high sCre. Conclusions and Clinical Importance This study demonstrates correlations between L‐FABP and current renal biomarkers for chronic kidney disease in cats, such as sCre and SDMA. Liver‐type fatty acid‐binding protein may be a potential biomarker to predict early pathophysiological events in feline kidneys.
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Affiliation(s)
- Masaaki Katayama
- Faculty of Agriculture, Cooperative Department of Veterinary Clinical Medicine, Iwate University, Morioka, Iwate, Japan
| | | | - Tamako Miyazaki
- Faculty of Agriculture, Department of Biological Chemistry and Food Sciences, Iwate University, Morioka, Iwate, Japan
| | - Rieko Katayama
- Faculty of Agriculture, Department of Biological Chemistry and Food Sciences, Iwate University, Morioka, Iwate, Japan
| | - Nobuko Wakamatsu
- Department of Pathobiological Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana
| | - Misa Ohno
- Department of Pathobiological Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge, Louisiana
| | - Tetsuro Yamashita
- Faculty of Agriculture, Department of Biological Chemistry and Food Sciences, Iwate University, Morioka, Iwate, Japan
| | | | | | - Masao Miyazaki
- Faculty of Agriculture, Department of Biological Chemistry and Food Sciences, Iwate University, Morioka, Iwate, Japan
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Lee JW, Moen EL, Punshon T, Hoen AG, Stewart D, Li H, Karagas MR, Gui J. An Integrated Gaussian Graphical Model to evaluate the impact of exposures on metabolic networks. Comput Biol Med 2019; 114:103417. [PMID: 31521894 PMCID: PMC6817396 DOI: 10.1016/j.compbiomed.2019.103417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 08/25/2019] [Accepted: 08/26/2019] [Indexed: 02/07/2023]
Abstract
Examining the effects of exogenous exposures on complex metabolic processes poses the unique challenge of identifying interactions among a large number of metabolites. Recent progress in the quantification of the metabolome through mass spectrometry (MS) and nuclear magnetic resonance (NMR) has given rise to high-dimensional biomedical data of specific metabolites that can be leveraged to study their effects in humans. These metabolic interactions can be evaluated using probabilistic graphical models (PGMs), which define conditional dependence and independence between components within and between heterogeneous biomedical datasets. This method allows for the detection and recovery of valuable but latent information that cannot be easily detected by other currently existing methods. Here, we develop a PGM method, referred to as an "Integrated Gaussian Graphical Model (IGGM)", to incorporate exposure concentrations of seven trace elements-arsenic (As), lead (Pb), mercury (Hg), cadmium (Cd), zinc (Zn), selenium (Se) and copper (Cu-into metabolic networks. We first conducted a simulation study demonstrating that the integration of trace elements into metabolomics data can improve the accuracy of detecting latent interactions of metabolites impacted by exposure in the network. We tested parameters such as sample size and the number of neighboring metabolites of a chosen trace element for their impact on the accuracy of detecting metabolite interactions. We then applied this method to measurements of cord blood plasma metabolites and placental trace elements collected from newborns in the New Hampshire Birth Cohort Study (NHBCS). We found that our approach can identify latent interactions among metabolites that are related to trace element concentrations. Application to similarly structured data may contribute to our understanding of the complex interplay between exposure-related metabolic interactions that are important for human health.
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Affiliation(s)
- Jai Woo Lee
- Institute for Quantitative Biomedical Sciences, Dartmouth College, Hanover, NH, USA
| | - Erika L Moen
- Department of Biomedical Data Science, Geisel School of Medicine, Lebanon, NH, USA
| | - Tracy Punshon
- Department of Biological Sciences, Dartmouth College, Hanover, NH, USA
| | - Anne G Hoen
- Department of Biomedical Data Science, Geisel School of Medicine, Lebanon, NH, USA; Department of Epidemiology, Geisel School of Medicine, Lebanon, NH, USA
| | - Delisha Stewart
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hongzhe Li
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadephia, PA, USA
| | | | - Jiang Gui
- Department of Biomedical Data Science, Geisel School of Medicine, Lebanon, NH, USA.
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Sargent HJ, Jepson RE, Chang YM, Biourge VC, Bijsmans ES, Elliott J. Fibroblast growth factor 23 and symmetric dimethylarginine concentrations in geriatric cats. J Vet Intern Med 2019; 33:2657-2664. [PMID: 31568615 PMCID: PMC6872607 DOI: 10.1111/jvim.15590] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 07/24/2019] [Indexed: 01/02/2023] Open
Abstract
Background Fibroblast growth factor 23 (FGF23) is a phosphaturic hormone that is increased in azotemic cats with chronic kidney disease (CKD) and predictive of the onset of azotemia in older cats. The introduction of symmetric dimethylarginine (SDMA) as a biomarker of glomerular filtration rate has led to the identification of cats in which SDMA is increased, but plasma creatinine concentrations remains within reference range. There is currently little understanding of the metabolic changes present in such cats. Objectives To examine the relationship between plasma FGF23 and SDMA concentrations in non‐azotemic geriatric cats. Animals Records of a cross section of client‐owned cats (n = 143) without azotemic CKD. Methods Clinicopathological information was obtained from cats (≥ 9 years) from records of 2 first opinion practices. The relationship between plasma SDMA and FGF23 concentrations was examined using Spearman's correlation and variables compared using the Mann‐Whitney U test. Results Cats with increased SDMA concentrations had significantly higher plasma FGF23 (P < .001) and creatinine (P < .001) concentrations compared to cats with SDMA concentrations within reference range. A weak positive relationship was demonstrated between plasma FGF23 and SDMA concentrations (r = .35, P < .001) and between plasma FGF23 and creatinine (r = .23, P = .005) concentrations. Conclusions and Clinical Importance More cats with increased SDMA concentrations had higher FGF23 concentrations than those with SDMA concentrations within the reference range, suggesting the presence of an alteration in phosphate homeostasis. Further studies are warranted to identify influencing factors and to explore the utility of FGF23 concentration to inform management of cats with early stage CKD.
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Affiliation(s)
- Hannah J Sargent
- Department of Comparative Biomedical Science, Royal Veterinary College, University of London, London, United Kingdom
| | - Rosanne E Jepson
- Department of Clinical Science and Services Royal Veterinary College, University of London, London, United Kingdom
| | - Yu-Mei Chang
- Research Support Office, Royal Veterinary College, University of London, London, United Kingdom
| | | | | | - Jonathan Elliott
- Department of Comparative Biomedical Science, Royal Veterinary College, University of London, London, United Kingdom
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Bradley R, Tagkopoulos I, Kim M, Kokkinos Y, Panagiotakos T, Kennedy J, De Meyer G, Watson P, Elliott J. Predicting early risk of chronic kidney disease in cats using routine clinical laboratory tests and machine learning. J Vet Intern Med 2019; 33:2644-2656. [PMID: 31557361 PMCID: PMC6872623 DOI: 10.1111/jvim.15623] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 08/29/2019] [Indexed: 02/01/2023] Open
Abstract
Background Advanced machine learning methods combined with large sets of health screening data provide opportunities for diagnostic value in human and veterinary medicine. Hypothesis/Objectives To derive a model to predict the risk of cats developing chronic kidney disease (CKD) using data from electronic health records (EHRs) collected during routine veterinary practice. Animals A total of 106 251 cats that attended Banfield Pet Hospitals between January 1, 1995, and December 31, 2017. Methods Longitudinal EHRs from Banfield Pet Hospitals were extracted and randomly split into 2 parts. The first 67% of the data were used to build a prediction model, which included feature selection and identification of the optimal neural network type and architecture. The remaining unseen EHRs were used to evaluate the model performance. Results The final model was a recurrent neural network (RNN) with 4 features (creatinine, blood urea nitrogen, urine specific gravity, and age). When predicting CKD near the point of diagnosis, the model displayed a sensitivity of 90.7% and a specificity of 98.9%. Model sensitivity decreased when predicting the risk of CKD with a longer horizon, having 63.0% sensitivity 1 year before diagnosis and 44.2% 2 years before diagnosis, but with specificity remaining around 99%. Conclusions and clinical importance The use of models based on machine learning can support veterinary decision making by improving early identification of CKD.
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Affiliation(s)
- Richard Bradley
- WALTHAM® Centre for Pet Nutrition, Freeby Lane, Waltham on the Wolds, Leicestershire, United Kingdom
| | - Ilias Tagkopoulos
- Department of Computer Science and Genome Center, University of California, Davis, California.,Process Integration and Predictive Analytics, PIPA LLC, Davis, California
| | - Minseung Kim
- Process Integration and Predictive Analytics, PIPA LLC, Davis, California
| | - Yiannis Kokkinos
- Process Integration and Predictive Analytics, PIPA LLC, Davis, California
| | | | | | - Geert De Meyer
- WALTHAM® Centre for Pet Nutrition, Freeby Lane, Waltham on the Wolds, Leicestershire, United Kingdom
| | - Phillip Watson
- WALTHAM® Centre for Pet Nutrition, Freeby Lane, Waltham on the Wolds, Leicestershire, United Kingdom
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
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EVALUATION OF SYMMETRIC DIMETHYLARGININE AS AN EARLY BIOMARKER OF CHRONIC KIDNEY DISEASE IN CAPTIVE CHEETAHS (ACINONYX JUBATUS). J Zoo Wildl Med 2019; 48:874-877. [PMID: 28920795 DOI: 10.1638/2016-0224.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Symmetric dimethylarginine (SDMA) has been shown to be a valuable biomarker for early detection of chronic kidney disease (CKD) in canine and feline patients. Recognition of early (subclinical) kidney disease would be of value in cheetahs (Acinonyx jubatus) as prevalence of CKD is relatively high in this species in captivity. Fifty-eight banked serum and plasma samples from seven adult cheetahs that died of CKD were analyzed for creatinine, urea, and SDMA. A marked increase in SDMA was noted on five of the tested cheetahs earlier than the rise of serum creatinine and urea (estimated 8-35 mo; mean 21.4 mo; median 22 mo). SDMA appears as an early biomarker to evaluate renal function for the diagnosis of CKD in cheetahs regardless of the cause of this disease.
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Covey HL, Chang YM, Elliott J, Syme HM. Changes in thyroid and renal function after bilateral thyroidectomy in cats. J Vet Intern Med 2019; 33:508-515. [PMID: 30758070 PMCID: PMC6430951 DOI: 10.1111/jvim.15450] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 01/28/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Iatrogenic hypothyroidism might worsen the prognosis of cats with azotemic CKD after thyroidectomy. Varying thyroxine concentrations influence utility of creatinine in assessing renal function. Symmetric dimethylarginine (SDMA) has limited studies in cats with changing thyroid status. OBJECTIVES Thyroid status is stable 6 months post-thyroidectomy. Symmetric dimethylarginine and creatinine are linearly associated without influence from total thyroxine concentration (tT4). ANIMALS Electronic records of 2 first opinion practices were searched using the term "thyroidectomy" to include 81 client-owned cats that had undergone bilateral thyroidectomy. METHODS Retrospective cross-sectional study assessing thyroid hormone concentrations of 68 cats within 6 months of surgery. A longitudinal study of thyroid status in 23 cats with >18 months follow-up post-thyroidectomy. A generalized estimating equation assessed the associations of bodyweight, tT4 and creatinine concentrations on SDMA concentration. RESULTS Sixty-eight cats had follow-up within 6 months. Fifteen cats (22%) had persistent, or recurrent, hyperthyroidism and 33 cats (49%) were hypothyroid. Twenty-three of the euthyroid/hypothyroid cats had long-term follow-up (595-1955 days); 4 cats (17%) remained hypothyroid, 19 cats (83%) were euthyroid (often transiently), and 9 of 23 cats (44%) developed recurrent hyperthyroidism. Symmetric dimethylarginine and creatinine were linearly associated, but hyperthyroid cats had higher SDMA concentrations, relative to creatinine (P = .003). CONCLUSIONS AND CLINICAL IMPORTANCE Cats have changes in thyroid function for years after bilateral thyroidectomy, with a high incidence of recurrent hyperthyroidism. Both SDMA and creatinine are affected by thyroxine concentrations, and the effect is greater in hyperthyroid cats.
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Affiliation(s)
- Heather L Covey
- Department of Clinical Science and Services, Small Animal Medicine and Surgery Group, The Royal Veterinary College, Hertfordshire, United Kingdom
| | - Yu-Mei Chang
- Research Support Office, The Royal Veterinary College, London, United Kingdom
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, The Royal Veterinary College, London, United Kingdom
| | - Harriet M Syme
- Department of Clinical Science and Services, Small Animal Medicine and Surgery Group, The Royal Veterinary College, Hertfordshire, United Kingdom
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Buresova E, Stock E, Paepe D, Stammeleer L, Vandermeulen E, Smets P, Duchateau L, Lefebvre HP, Daminet S. Assessment of symmetric dimethylarginine as a biomarker of renal function in hyperthyroid cats treated with radioiodine. J Vet Intern Med 2019; 33:516-522. [PMID: 30632628 PMCID: PMC6430927 DOI: 10.1111/jvim.15407] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/29/2018] [Indexed: 12/27/2022] Open
Abstract
Background Measurement of serum creatinine (sCr) and urea nitrogen fail to detect decreased renal function in many hyperthyroid cats because of low muscle mass and glomerular hyperfiltration of affected cats. Serum symmetric dimethylarginine (sSDMA) is an earlier and more sensitive renal biomarker than sCr. Objective Evaluate sSDMA as a biomarker of renal function in hyperthyroid cats before (T0) and 1 month after (T1) radioiodine (131I) treatment. Animals Forty‐seven client‐owned hyperthyroid nonazotemic cats were evaluated at T0 and T1. Methods A prospective study in which sCr and sSDMA concentrations were determined in 47 hyperthyroid cats at T0 and at T1. Glomerular filtration rate (GFR) was estimated at T0 and T1 in 10 of these 47 cats using plasma exogenous creatinine clearance test. Results Serum SDMA was elevated (>14 μg/dL) in 6 of 47 cats at T0 and normalized after treatment in 4 of those cats. All cats remained nonazotemic after treatment. In 10 cats in which GFR was measured, correlation between GFR and sSDMA was low and not significant (τb = −0.35, P = .17 at T0 and τb = −.22, P = .41 at T1), whereas correlation between GFR and sCr was moderate and significant (τb = −0.52, P < .05 at T0 and τb = −.53, P = <.05 at T1). Conclusions and Clinical Importance Careful interpretation of mildly increased sSDMA with normal sCr in hyperthyroid cats is warranted as sSDMA values might normalize after resolution of hyperthyroidism in some cats. In this population of hyperthyroid cats, sSDMA was poorly correlated with GFR.
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Affiliation(s)
- Eva Buresova
- The Small Animal Department, Ghent University, Merelbeke, Belgium
| | - Emmelie Stock
- The Department of Medical Imaging of Domestic Animals, Ghent University, Merelbeke, Belgium
| | - Dominique Paepe
- The Small Animal Department, Ghent University, Merelbeke, Belgium
| | - Lisa Stammeleer
- The Small Animal Department, Ghent University, Merelbeke, Belgium
| | - Eva Vandermeulen
- The Department of Medical Imaging of Domestic Animals, Ghent University, Merelbeke, Belgium
| | - Pascale Smets
- The Small Animal Department, Ghent University, Merelbeke, Belgium
| | - Luc Duchateau
- The Biometrics Research Group, Ghent University, Merelbeke, Belgium
| | - Herve P Lefebvre
- The Department of Physiology, École Nationale Vétérinaire de Toulouse, Toulouse, France
| | - Sylvie Daminet
- The Small Animal Department, Ghent University, Merelbeke, Belgium
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49
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Ernst R, Ogeer J, McCrann D, Cross J, Strong-Townsend M, Friis H, Coyne M, Clements C, Drake C, Murphy R. Comparative performance of IDEXX SDMA Test and the DLD SDMA ELISA for the measurement of SDMA in canine and feline serum. PLoS One 2018; 13:e0205030. [PMID: 30321185 PMCID: PMC6188631 DOI: 10.1371/journal.pone.0205030] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/17/2018] [Indexed: 01/09/2023] Open
Abstract
Kidney disease is common in companion animals, and traditionally diagnosed with serum creatinine concentration (sCr), blood urea nitrogen, and abnormal urinalysis findings. Symmetric dimethylarginine (SDMA) is a novel kidney biomarker that reflects glomerular filtration rate, increasing earlier than sCr with acute kidney injury and chronic kidney disease. This prospective study compared accuracy and precision of two commercial SDMA assays, the IDEXX SDMA Test and the DLD SDMA ELISA, relative to the established reference method, liquid chromatography/mass spectrometry (LC-MS). Thirty canine and 30 feline pooled serum samples were used to evaluate accuracy compared to LC-MS. Pooled canine samples with a low SDMA concentration and pooled feline samples with a high SDMA concentration were used to evaluate precision. Using a best fit linear model, the IDEXX SDMA Test resulted in a slope of 1.06 and an intercept of 0.34, with R2 = 0.99, and the DLD SDMA ELISA resulted in a slope of 0.37 and an intercept of 11.33, with R2 = 0.27, when compared to LC-MS. Estimated bias over a clinically relevant range for SDMA (10–45 μg/dL) was 1–2 μg/dL for the IDEXX SDMA Test, while DLD SDMA ELISA showed considerable bias, 5–8 μg/dL. Day-to-day precision analysis of the low SDMA concentration samples showed 7.7% total coefficient of variation (CV) for the IDEXX SDMA Test and 31.1% for the DLD SDMA ELISA. For the high SDMA concentration samples, total CV was 2.3% for the IDEXX SDMA Test and 28.2% for the DLD SDMA ELISA. In this study the IDEXX SDMA Test was more accurate and more precise in macroscopically normal serum than the DLD SDMA ELISA when compared to the reference method of LC-MS. The IDEXX SDMA Test is more suitable for clinical use in the diagnosis and monitoring of kidney disease in dogs and cats.
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Affiliation(s)
- Rie Ernst
- Fredrikstad Dyrehospital, Fredrikstad, Norway
| | - Jennifer Ogeer
- IDEXX Laboratories, Inc., Westbrook, Maine, United States of America
| | - Donald McCrann
- IDEXX Laboratories, Inc., Westbrook, Maine, United States of America
| | - Julie Cross
- IDEXX Laboratories, Inc., Westbrook, Maine, United States of America
| | | | - Hanne Friis
- IDEXX Europe B.V. Hoofddorp, The Netherlands
| | - Michael Coyne
- IDEXX Laboratories, Inc., Westbrook, Maine, United States of America
- * E-mail:
| | - Celeste Clements
- IDEXX Laboratories, Inc., Westbrook, Maine, United States of America
| | - Corie Drake
- IDEXX Laboratories, Inc., Westbrook, Maine, United States of America
| | - Rachel Murphy
- IDEXX Laboratories, Inc., Westbrook, Maine, United States of America
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50
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Köster LS, Peda A, Fraites T, Sithole F. A preliminary investigation into the prognostic relevance of symmetric dimethylarginine in critically ill dogs. J Vet Emerg Crit Care (San Antonio) 2018; 28:527-531. [PMID: 30302896 DOI: 10.1111/vec.12780] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 12/23/2016] [Accepted: 12/30/2016] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To determine if there is an association between the concentration of symmetric dimethylarginine (SDMA) in dogs measured at the time of admission with the severity of critical illness and short-term mortality. DESIGN This prospective observational study recruited critically ill dogs with heterogeneous diagnoses and then classified their disease severity using the acute patient physiologic and laboratory evaluation complete score as having either a good (<30) or poor (≥30) prognosis. SETTING This study was conducted at Ross University Veterinary Clinic between January and November 2015. ANIMALS After exclusion of dogs diagnosed with acute kidney injury, 22 critically ill dogs and 7 control dogs were included in the study. INTERVENTIONS Each dog was assigned an acute patient physiologic and laboratory evaluation score calculated by the summation of individual scores allocated to selected clinical, focused assessment by sonography, hematological, and biochemistry results. Plasma SDMA concentrations were measured for all dogs at the time of admission. MEASUREMENT AND MAIN RESULTS There was no difference identified in SDMA concentrations between dogs with a severe category of disease as compared to mild to moderate category, or critically ill dogs compared to control dogs. There was also no difference identified in SDMA concentrations in survivors as compared to nonsurvivors. Similarly, SDMA concentration was not higher in nonsurvivors than in survivors (P = 0.968). In this population of dogs, SDMA was not a prognostic indicator. CONCLUSION Further work may be warranted in specific populations of animals but based upon this work SDMA is likely of little relevance.
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Affiliation(s)
- Liza Sally Köster
- Center for Integrative Mammalian Research, Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St Kitts and Nevis, West Indies
| | - Andrea Peda
- Ross University Veterinary Clinic, Ross University School of Veterinary Medicine, Basseterre, St Kitts and Nevis, West Indies
| | - Trellor Fraites
- Laboratory Services, Ross University School of Veterinary Medicine, Basseterre, St Kitts and Nevis, West Indies
| | - Fortune Sithole
- One Health Center for Zoonosis and Tropical Veterinary Medicine, Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, St Kitts and Nevis, West Indies
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